Effectiveness of early diagnosis of cerebral palsy guideline implementation: a systematic review

被引：7
作者：
Mcnamara, Lynda M. [1 ]
Scott, Karen M. [1 ]
Boyd, Roslyn N. [2 ]
Webb, Annabel E. [3 ]
Taifalos, Chloe J. [2 ]
Novak, Iona E. [3 ,4 ]
机构：
[1] Univ Sydney, Fac Med & Hlth, Sydney Med Sch, Specialty Child & Adolescent Hlth, Sydney, Australia
[2] Univ Queensland, Fac Med, Queensland Cerebral Palsy & Rehabil Res Ctr, Brisbane, Australia
[3] Univ Sydney, Cerebral Palsy Alliance Res Inst, Sydney Med Sch, Specialty Child & Adolescent Hlth,Fac Med & Hlth, Sydney, Australia
[4] Univ Sydney, Fac Med & Hlth, Sydney, Australia
来源：
MINERVA PEDIATRICS | 2023年
基金：
澳大利亚国家健康与医学研究理事会;
关键词：
Translational science; biomedical; Early diagnosis; Cerebral palsy; Patient outcome assessment; KNOWLEDGE TRANSLATION; QUALITY; INTERVENTIONS; CARE; TIME;
D O I：
10.23736/S2724-5276.22.07112-9
中图分类号：
R72 [儿科学];
学科分类号：
100202 ;
摘要：
INTRODUCTION: Tailored implementation interventions are required to overcome the diagnostic research-practice gap for cerebral palsy (CP). Evaluating the impact of interventions on patient outcomes is a priority. This review aimed to summarize the established evidence for the effectiveness of guideline implementations in lowering the age of CP diagnosis.EVIDENCE ACQUISITION: A systematic review was conducted according to PRISMA. CINAHL, Embase, PubMed and MEDLINE were searched (2017-October 2022). Inclusion criteria were studies that evaluated effect of CP guideline interventions on health professional behaviour or patient outcomes. GRADE was used to determine quality. Studies were coded for use of theory (Theory Coding Scheme). Meta-analysis was performed and a standardized metric used to summarize statistics of intervention effect estimates. EVIDENCE SYNTHESIS: Of (N.=249) records screened, (N.=7) studies met inclusion, comprising interventions following infants less than 2 years of age with CP risk factors (N.=6280). Guideline feasibility in clinical practice was established through health professional adherence and patient satisfaction. Efficacy of patient outcome of CP diagnosis by 12 months of age was established in all studies. Weighted averages were: (1) high-risk of CP (N.=2) 4.2 months and (2) CP diagnosis (N.=5) at 11.6 months. Meta-analysis of (N.=2) studies found a large, pooled effect size Z = 3.00 (P=0.003) favoring implementation interventions lowering age of diagnosis by 7.50 months, however study heterogeneity was high. A paucity of theoretical frameworks were identified in this review.CONCLUSIONS: Multifaceted interventions to implement the early diagnosis of CP guideline are effective in improving patient outcomes by lowering the age of CP diagnosis in high-risk infant follow-up clinics. Further targeted health professional interventions including low-risk infant populations are warranted.(Cite this article as: McNamara LM, Scott KM, Boyd RN, Webb AE, Taifalos CJ, Novak IE. Effectiveness of early diagnosis of cerebral palsy guideline implementation: a systematic review. Minerva Pediatr 2023 Apr 06. DOI: 10.23736/ S2724-5276.22.07112-9)
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页数：26
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