Canadian Association of Radiologists Pediatric Imaging Referral Guideline

Area of Science:

• Pediatric Radiology
• Clinical Guideline Development
• Evidence-Based Medicine

Background:

• The Canadian Association of Radiologists (CAR) Pediatric Expert Panel convened to address the need for standardized pediatric referral guidelines.
• A multidisciplinary panel including pediatric physicians, a patient advisor, and an epidemiologist was assembled.
• Existing referral practices lacked systematic evidence-based recommendations for numerous pediatric clinical scenarios.

Purpose of the Study:

• To develop evidence-based referral recommendations for pediatric clinical and diagnostic scenarios.
• To synthesize existing systematic guidelines and apply a robust framework for recommendation development.
• To provide clear guidance for the appropriate referral of pediatric patients across various subspecialties.

Main Methods:

• A rapid scoping review identified 32 systematically produced referral guidelines.
• Recommendations from these guidelines were contextualized using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework.
• 133 recommendation statements were developed across 50 identified pediatric clinical/diagnostic scenarios.

Main Results:

• The guideline development process synthesized evidence from 32 existing guidelines.
• 133 distinct referral recommendations were formulated for 50 pediatric scenarios.
• Recommendations cover key areas including head, neck, spine, hip, chest, abdomen, genitourinary, and non-accidental trauma.

Conclusions:

• The developed guideline provides a comprehensive set of evidence-based referral recommendations for pediatric care.
• These recommendations aim to improve the consistency and appropriateness of pediatric referrals.
• The guideline serves as a valuable resource for clinicians managing pediatric patients across multiple disciplines.