Browsing by Author "Da Dalt, Liviana"

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    Availability and use of rapid diagnostic tests for the management of acute childhood infections in Europe : A cross-sectional survey of paediatricians
    (2022-12) Dewez, Juan Emmanuel; Pembrey, Lucy; Nijman, Ruud G.; del Torso, Stefano; Grossman, Zachi; Hadjipanayis, Adamos; Van Esso, Diego; Lim, Emma; Emonts, Marieke; Burns, James; Gras-LeGuen, Christèle; Kohlfuerst, Daniela; Dornbusch, Hans Jürgen; Brengel-Pesce, Karen; Mallet, Francois; von Both, Ulrich; Tsolia, Maria; Eleftheriou, Irini; Zavadska, Dace; de Groot, Ronald; van der Flier, Michiel; Moll, Henriëtte; Hagedoorn, Nienke; Borensztajn, Dorine; Oostenbrink, Rianne; Kuijpers, Taco; Pokorn, Marko; Vincek, Katarina; Martinó n-Torres, Federico; Rivero, Irene; Agyeman, Philipp; Carrol, Enitan D.; Paulus, Stéphane; Cunnington, Aubrey; Herberg, Jethro; Levin, Michael; Mujkić, Aida; Geitmann, Karin; Da Dalt, Liviana; Valiulis, Arunas; Lapatto, Risto; Syridou, Garyfallia; Altorjai, Péter; Torpiano, Paul; Størdal, Ketil; Illy, Károly; Mazur, Artur; Spreitzer, Mateja Vintar; Rios, Joana; Wyder, Corinne; Romankevych, Ivanna; Basmaci, Romain; Ibanez-Mico, Salvador; Yeung, Shunmay
    Background Point-of-care-tests (POCTs) have been advocated to optimise care in patients with infections but their actual use varies. This study aimed to estimate the variability in the adoption of current POCTs by paediatricians across Europe, and to explore the determinants of variability. Methods and findings A cross-sectional survey was conducted of hospital and primary care paediatricians, recruited through professional networks. Questions focused on the availability and use of currently available POCTs. Data were analysed descriptively and using Median Odds Ratio (MOR) to measure variation between countries. Multilevel regression modelling using changes in the area under the receiver operating characteristic curve of models were used to assess the contribution of individual or workplace versus country level factors, to the observed variation. The commonest POCT was urine dipsticks (UD) which were available to >80% of primary care and hospital paediatricians in 68% (13/19) and 79% (23/29) countries, respectively. Availability of all POCTs varied between countries. In primary care, the country (MOR) varied from 1.61 (95%CI: 1.04-2.58) for lactate to 7.28 (95%CI: 3.04-24.35) for UD. In hospitals, the country MOR varied from 1.37 (95%CI:1.04-1.80) for lactate to 11.93 (95% CI:3.35-72.23) for UD. Most paediatricians in primary care (69%, 795/1154) and hospital (81%, 962/1188) would use a diagnostic test in the case scenario of an infant with undifferentiated fever. Multilevel regression modelling showed that the country of work was more important in predicting both the availability and use of POCTs than individual or workplace characteristics. Conclusion There is substantial variability in the adoption of POCTs for the management of acute infections in children across Europe. To inform future implementation of both existing and innovative tests, further research is needed to understand what drives the variation between countries, the needs of frontline clinicians, and the role of diagnostic tests in the management of acute childhood infections.
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    Research priorities for European paediatric emergency medicine
    (2019-09) Bressan, Silvia; Titomanlio, Luigi; Gomez, Borja; Mintegi, Santiago; Gervaix, Alain; Parri, Niccolo; Da Dalt, Liviana; Moll, Henriette A.; Waisman, Yehezkel; Maconochie, Ian K.; Oostenbrink, Rianne; Er, Anil; Anil, Murat; Bal, Alkan; Manzano, Sergio; Lacroix, Laurance; Galetto, Annick; Beattie, Tom; Bidlingmaier, Christoph; de Lucas, Nieves; Maranon, Rafael; Pucuka, Zanda; Loellgen, Ruth; Keitel, Kristina; Hoeffe, Julia; Geurts, Dorien; Dubos, Francois; Lyttle, Mark; Bognar, Zsolt; Simon, Gabor; Fodor, Laszlo; Romanengo, Marta; Gras-le-Guen, Christele; Greber-Platzer, Susanne; Cubells, Carles Luaces; Teksam, Ozlem; Turan, Caner; van de Voorde, Patrick; Basmaci, Romain; Frassanito, Antonella; Saz, Ulas; Irfanos, Ionannis; Sotoca, Jorge; Berant, Ron; Farrugia, Ruth; Velasco, Roberto; Nijman, Ruud; Macao, Patricia
    Objective Research in European Paediatric Emergency Medicine (REPEM) network is a collaborative group of 69 paediatric emergency medicine (PEM) physicians from 20 countries in Europe, initiated in 2006. To further improve paediatric emergency care in Europe, the aim of this study was to define research priorities for PEM in Europe to guide the development of future research projects. Design and Setting We carried out an online survey in a modified three-stage Delphi study. Eligible participants were members of the REPEM network. In stage 1, the REPEM steering committee prepared a list of research topics. In stage 2, REPEM members rated on a 6-point scale research topics and they could add research topics and comment on the list for further refinement. Stage 3 included further prioritisation using the Hanlon Process of Prioritisation (HPP) to give more emphasis to the feasibility of a research topic. Results Based on 52 respondents (response rates per stage varying from 41% to 57%), we identified the conditions 'fever', 'sepsis' and 'respiratory infections', and the processes/interventions 'biomarkers', 'risk stratification' and 'practice variation' as common themes of research interest. The HPP identified highest priority for 4 of the 5 highest prioritised items by the Delphi process, incorporating prevalence and severity of each condition and feasibility of undertaking such research. Conclusions While the high diversity in emergency department (ED) populations, cultures, healthcare systems and healthcare delivery in European PEM prompts to focus on practice variation of ED conditions, our defined research priority list will help guide further collaborative research efforts within the REPEM network to improve PEM care in Europe.