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Objectives Artificial intelligence (AI) tools are becoming more available in modern healthcare, particularly in radiology, although less attention has been paid to applications for children and young people. In the development of these, it is critical their views are heard. Materials and methods A national, online survey was publicised to UK schools, universities and charity partners encouraging any child or young adult to participate. The survey was “live” for one year (June 2022 to 2023). Questions about views of AI in general, and in specific circumstances (e.g. bone fractures) were asked. Results One hundred and seventy-one eligible responses were received, with a mean age of 19 years (6–23 years) with representation across all 4 UK nations. Most respondents agreed or strongly agreed they wanted to know the accuracy of an AI tool that was being used (122/171, 71.3%), that accuracy was more important than speed (113/171, 66.1%), and that AI should be used with human oversight (110/171, 64.3%). Many respondents (73/171, 42.7%) felt AI would be more accurate at finding problems on bone X-rays than humans, with almost all respondents who had sustained a missed fracture strongly agreeing with that sentiment (12/14, 85.7%). Conclusions Children and young people in our survey had positive views regarding AI, and felt it should be integrated into modern healthcare, but expressed a preference for a “medical professional in the loop” and accuracy of findings over speed. Key themes regarding information on AI performance and governance were raised and should be considered prior to future AI implementation for paediatric healthcare. Clinical relevance statement Artificial intelligence (AI) integration into clinical practice must consider all stakeholders, especially paediatric patients who have largely been ignored. Children and young people favour AI involvement with human oversight, seek assurances for safety, accuracy, and clear accountability in case of failures. Key Points Paediatric patient’s needs and voices are often overlooked in AI tool design and deployment. Children and young people approved of AI, if paired with human oversight and reliability. Children and young people are stakeholders for developing and deploying AI tools in paediatrics.
Objectives Artificial intelligence (AI) tools are becoming more available in modern healthcare, particularly in radiology, although less attention has been paid to applications for children and young people. In the development of these, it is critical their views are heard. Materials and methods A national, online survey was publicised to UK schools, universities and charity partners encouraging any child or young adult to participate. The survey was “live” for one year (June 2022 to 2023). Questions about views of AI in general, and in specific circumstances (e.g. bone fractures) were asked. Results One hundred and seventy-one eligible responses were received, with a mean age of 19 years (6–23 years) with representation across all 4 UK nations. Most respondents agreed or strongly agreed they wanted to know the accuracy of an AI tool that was being used (122/171, 71.3%), that accuracy was more important than speed (113/171, 66.1%), and that AI should be used with human oversight (110/171, 64.3%). Many respondents (73/171, 42.7%) felt AI would be more accurate at finding problems on bone X-rays than humans, with almost all respondents who had sustained a missed fracture strongly agreeing with that sentiment (12/14, 85.7%). Conclusions Children and young people in our survey had positive views regarding AI, and felt it should be integrated into modern healthcare, but expressed a preference for a “medical professional in the loop” and accuracy of findings over speed. Key themes regarding information on AI performance and governance were raised and should be considered prior to future AI implementation for paediatric healthcare. Clinical relevance statement Artificial intelligence (AI) integration into clinical practice must consider all stakeholders, especially paediatric patients who have largely been ignored. Children and young people favour AI involvement with human oversight, seek assurances for safety, accuracy, and clear accountability in case of failures. Key Points Paediatric patient’s needs and voices are often overlooked in AI tool design and deployment. Children and young people approved of AI, if paired with human oversight and reliability. Children and young people are stakeholders for developing and deploying AI tools in paediatrics.
Purpose: Virtual service delivery models in audiology have become more accessible due to recent technological advancement and improved system-level uptake following COVID-19. Although current evidence identifies the benefits of virtual care to families with children who are d/Deaf or hard of hearing and supports its use in practice, this delivery model is still underutilized. This research aimed to gain consensus on an evidence-informed virtual caregiver participation framework developed from a scoping review of the communication sciences and disorders literature. Method: A two-round modified e-Delphi study was conducted to survey 26 knowledge users from four different countries with experience in virtual audiology care, including caregivers, audiologists, researchers, and organizational leaders. The study employed Delphi techniques, building from a scoping review to synthesize existing literature informing the knowledge gap, including online surveys and team discussions. Consensus was defined numerically (75% agreement) and by comparing and interpreting text-based responses. Results: The resulting framework grouped nine categories of caregiver participation in virtual care according to three main readiness domains: core readiness (opportunities to participate, perceived value, and willingness to participate), engagement readiness (child capacity, family–provider relationship, and role in the care process), and structural readiness (environment for participation, support, and technology). Conclusion: This work adds novel contributions to the field, through the development of a framework for caregiver participation in virtual audiology care, that can be used to support family involvement and will guide clinical tool development and future research efforts.
BackgroundHospital-in-the-Home (HITH) delivers hospital level care to patients in the comfort of their own home. Traditionally HITH involves clinicians travelling to patients' homes. We designed and implemented a virtual model of care leveraging a combination of virtual health modalities for children with COVID-19 in response to rising patient numbers, infection risk and pressures on protective equipment. In contrast to other models for COVID-19 infection in Australia at the time, our HITH service catered only for children who were unwell enough to meet criteria for hospitalisation (ie bed-replacement).AimsTo measure the feasibility, acceptability, safety and impact of a virtual model of care for managing children with COVID-19 infection requiring hospital-level care.MethodsRetrospective study of a new virtual model of care for all children admitted to the Royal Children's HITH service with COVID-19 infection between 7th October 2021 and 28th April 2022. The model consisted of at least daily video consultations, remote oximetry, symptom tracking, portal messaging and 24 h phone and video support. Patients were eligible if they met a certain level of severity (work of breathing, dehydration, lower oxygen saturations) without requiring intravenous fluids, oxygen support or intensive care. Online surveys were distributed to staff and consumers who experienced the model of care.Results331 patients were managed through the virtual HITH program with a mean length of stay of 3.5 days. Of these, 331 (100%) engaged in video consultations, 192 (58%) engaged in the patient portal and completed the symptom tracker a total of 634 times and communicated via a total of 783 messages. Consumer satisfaction (n = 31) was high (4.7/5) with the most useful aspect of the model rated as video consultation. Clinician satisfaction (n = 9) was also high with a net promoter score of 8.9. There were no adverse events at home. Eight children (2.4%) represented to hospital, 7 (2.1%) of whom were readmitted. The impact is represented by a total of 1,312 hospital bed-days saved in the seven-month period (2,249 bed-days per year). In addition, 1,480 home visits (travel time/ protective equipment/ infection risk) were avoided.ConclusionA virtual HITH program for COVID-19 in children is feasible, acceptable and safe and has a substantial impact on bed-days saved and nursing travel time. The implications for management of other acute respiratory viral illnesses that contribute to hospital bed pressure during winter months is immense. Virtual HITH is likely to be a key enabler of a sustainable healthcare system.
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