Put the Shovel Down*

Bergmann, Jules; Fackler, James C.

doi:10.1097/pcc.0000000000002244

Cited by 2 publications

(2 citation statements)

References 10 publications

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“…Since scores in pediatric intensive care are constantly evolving, understanding their updating is necessary, and the interpretation limits of their results should be sufficiently known, both for the clinician in his management (individual prognosis and inclusion in protocols, among others) and concerning performance analysis (need for regular adaptations before any conclusions). Therefore, the prospect of automated data collection that enables their calculation, facilitated by the computerization of services, is a necessity that manufacturers should consider ( 60 , 62 ). There is still a long way to go and we must not lose sight of the fact that informatics must be at the service of medicine and not the other way around.…”

Section: Discussionmentioning

confidence: 99%

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Severity of illness and organ dysfunction scoring systems in pediatric critical care: The impacts on clinician's practices and the future

Recher¹,

Leteurtre²,

Canon³

et al. 2022

Front. Pediatr.

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Severity and organ dysfunction (OD) scores are increasingly used in pediatric intensive care units (PICU). Therefore, this review aims to provide 1/ an updated state-of-the-art of severity scoring systems and OD scores in pediatric critical care, which explains 2/ the performance measurement tools and the significance of each tool in clinical practice and provides 3/ the usefulness, limits, and impact on future scores in PICU. The following two pediatric systems have been proposed: the PRISMIV, is used to collect data between 2 h before PICU admission and the first 4 h after PICU admission; the PIM3, is used to collect data during the first hour after PICU admission. The PELOD-2 and SOFApediatric scores were the most common OD scores available. Scores used in the PICU should help clinicians answer the following three questions: 1/ Are the most severely ill patients dying in my service: a good discrimination allow us to interpret that there are the most severe patients who died in my service. 2/ Does the overall number of deaths observed in my department consistent with the severity of patients? The standard mortality ratio allow us to determine whether the total number of deaths observed in our service over a given period is in adequacy with the number of deaths predicted, by considering the severity of patients on admission? 3/ Does the number of deaths observed by severity level in my department consistent with the severity of patients? The calibration enabled us to determine whether the number of deaths observed according to the severity of patients at PICU admission in a department over a given period is in adequacy with the number of deaths predicted, according to the severity of the patients at PICU admission. These scoring systems are not interpretable at the patient level. Scoring systems are used to describe patients with PICU in research and evaluate the service's case mix and performance. Therefore, the prospect of automated data collection, which permits their calculation, facilitated by the computerization of services, is a necessity that manufacturers should consider.

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Section: Discussionmentioning

confidence: 99%

“…Thus, EMR represents an extremely important element of discussion for the future. The challenges of the EMR are very well described ( 60 , 61 ). The development of the EMR must be done through a collaboration between engineers and pediatric intensive care physicians.…”

Section: Pediatric-scoring Systems: Use and Impacts On The Futurementioning

confidence: 99%