Early Magnetic Resonance Imaging Use in Clinical Care Pathways for Musculoskeletal Infections in Pediatric Patients: A Systematic Review
Notice bibliographique
Résumé
Background: Magnetic resonance imaging (MRI) is often used in the work-up for pediatric patients with musculoskeletal infections (MSKIs). The timing of MRI has been shown to impact surgical accuracy and clinical outcomes for MSKI patients. However, its use in clinical care pathways (CCPs) for suspected cases of MSKI in this population has not been thoroughly reviewed. The objective of this literature review is to determine whether the use of MRI in CCPs for suspected cases of MSKI improves clinical outcomes. Methods: A review was systematically conducted by 2 authors using studies from Ovid Embase, Ovid Medline, Scopus, Web of Science, and Google Scholar. Studies were screened for relevancy and inclusion criteria through the Covidence database. Retrospective cohort studies that discussed the use of MRI for MSKI in exclusively pediatric populations, published since 1990, and were written/translated to English were included. The quality of the included studies was assessed using tools for cohort studies from Cochrane and the National Center for Biotechnology Information. A qualitative summary of the results was used due to the small number of studies and variables reported in the included studies. A secondary search and review were conducted by the same 2 authors to identify more studies after the initial review. Results: The first search across 5 databases yielded 1,857 studies. Of these, 3 retrospective cohort studies were relevant to the topic of the review and met the inclusion criteria. The second search yielded 120 studies, but none were applicable for inclusion. The 3 included studies showed that early MRI improves diagnostic accuracy and surgical timing. They reported on the ability of MRI to define the full extent of an MSKI and identify adjacent infections preoperatively, which improves surgical outcomes and decreases complication rates. The studies reported that early MRI use in CCPs decreases reoperation rates and unnecessary surgeries. The authors also discussed how early MRI use can indirectly decrease hospital costs. Conclusions: Early use of MRI in suspected cases of MSKIs may allow for an accurate and timely diagnosis and may lead to early intervention and a decreased rate of complications. MRI can depict the full extent of infection and any adjacent infection(s), allowing for the correct intervention to be selected. This may decrease the number of unnecessary surgeries, thereby reducing reoperation rates, length of stay, and readmission rates. Key Concepts: (1)Magnetic resonance imaging (MRI) is a diagnostic tool for musculoskeletal infections (MSKIs).(2)Prioritizing early MRI in clinical care pathways of suspected cases of MSKIs may improve patient outcomes.(3)Benefits of early MRI for MSKI patients may include reducing unnecessary surgeries and reoperation rates. Level of Evidence: II.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,037 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,006 | 0,005 |
| Bibliométrie | 0,009 | 0,012 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».