Association Between Adherence to Guidelines and Patient Outcomes in Severe Pediatric Traumatic Brain Injury: A Scoping Review
Bibliographic record
Abstract
This scoping review aimed to systematically describe the literature reporting the relationship between guidelines adherence and outcomes in children with severe traumatic brain injury (TBI). The search for articles of interest was performed in the Pubmed, Embase, Cochrane Library, and Google Scholar databases. Two investigators independently screened publications from 2000 to March 2024 reporting the relationship between the implementation of a protocolized management or adherence to guidelines for severe pediatric TBI management and patient outcomes. Discrepancies regarding study eligibility were resolved by consensus, and with a third reviewer if needed. Inclusion criteria included pediatric severe TBI, reporting of clinical outcomes, with comparison of whether guidelines were respected or not. Among 2141 articles identified after the systematic search, eight articles were included in the review. The implementation of a management protocol for severe TBI was reported in five studies and was associated with a reduction in mortality and an improvement in functional prognosis. Three articles also highlighted a statistical association between adherence to guidelines and improved outcomes. In conclusion, guidelines adherence after a pediatric severe TBI was associated with improved survival and functional patient outcomes in all studies identified, although the strength of this observation is limited by the observational or pre-post design of all included studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.097 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.006 |
| Bibliometrics | 0.013 | 0.016 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".