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Comparing Practice Patterns Between Pediatric and General Emergency Medicine Physicians: A Scoping Review
Nnenna O Chime1, Jessica Katznelson, Sandeep Gangadharan
1From the *Department of Pediatrics, Albert Einstein College of Medicine and Children's Hospital at Montefiore, Bronx, NY; †Department of Pediatrics, Johns Hopkins University, Baltimore, MD; ‡Department of Pediatrics, Cohens Children's Hospital, Hofstra, Manhasset, NY; §Department of Pediatrics, University of Massachusetts School of Medicine, Worcester, MA; ∥Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI; and ¶Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
Insights
This review found limited research comparing pediatric emergency medicine (PEM) physicians and general emergency medicine-trained physicians (GEDPs) in treating children. More high-quality studies are needed to understand differences in care quality.
Area of Science:
- Emergency Medicine
- Pediatrics
- Health Services Research
Background:
- Acutely ill infants and children are treated by pediatric emergency medicine (PEM) physicians or general emergency medicine-trained physicians (GEDPs).
- Understanding practice pattern differences is crucial for optimizing pediatric emergency care.
Purpose of the Study:
- To conduct a scoping review of published literature comparing care for pediatric patients provided by PEM-trained physicians versus GEDPs.
- To identify research gaps in the comparison of these two groups of physicians.
Main Methods:
- A comprehensive literature search was performed in two main steps, including concept modification and article selection based on inclusion criteria.
- Two independent reviewers assessed study eligibility and quality, with data abstraction and author contact for missing information.
Main Results:
- The search identified 3137 titles and abstracts, with 20 articles reporting 19 studies included in the final analysis.
- Studies covered various conditions including fever, croup, bronchiolitis, asthma, urticaria, febrile seizures, and diabetic ketoacidosis.
- Research was categorized into type of care, diagnostic studies, medication administration, and process of care.
Conclusions:
- The review identified a lack of robust studies and significant heterogeneity in the literature comparing practice patterns of PEM-trained physicians and GEDPs.
- A systematic approach for reviewing literature on topics with unclear comparative terms across studies was outlined.
Objective:
Acutely ill infants and children presenting to the emergency department are treated by either physicians with pediatric emergency medicine (PEM) training or physicians without PEM training, a good proportion of which are general emergency medicine-trained physicians (GEDPs). This scoping review identified published literature comparing the care provided to infants and children (≤21 years of age) by PEM-trained physicians to that provided by GEDPs.
Methods:
The search was conducted in 2 main steps as follows: (1) initial literature search to identify available literature with evolving feedback from the group while simultaneously deciding search concepts as well as inclusion and exclusion criteria and (2) modification of search concepts and conduction of search using finalized concepts as well as review and selection of articles for final analysis using set inclusion criteria. Each study was independently assessed by 2 reviewers for eligibility and quality. Data were independently abstracted by reviewers, and authors were contacted for missing data.
Results:
Our search yielded 3137 titles and abstracts. Twenty articles reporting 19 studies were included in the final analysis. The studies were grouped under type of care, diagnostic studies, medication administration, and process of care. The studies addressed differences in the management of fever, croup, bronchiolitis, asthma, urticaria, febrile seizures, and diabetic ketoacidosis.
Conclusions:
This review highlights the lack of robust studies and heterogeneity of literature comparing practice patterns of PEM-trained physicians with GEDPs. We have outlined a systematic approach to reviewing a body of literature for topics that lack clear terms of comparison across studies.
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