71 Canadian practice patterns in the management of paediatric periorbital and orbital cellulitis: A national survey
Bibliographic record
Abstract
Abstract Background Periorbital and orbital cellulitis are common infections in the paediatric population requiring interdisciplinary management. However, there are no Canadian clinical practice guidelines to evaluate and manage these severe orbital infections, and wide variation in care. Objectives To describe clinical practice patterns in admission, diagnostic tests, antibiotic therapy, subspecialty consultation, and discharge recommendations across Canadian hospitals. Design/Methods A cross-sectional survey of general paediatricians at children’s and community hospitals across Canada, and paediatric emergency department (ED) physicians at children’s hospitals was conducted. The survey was distributed through the Canadian Paediatric Inpatient Research Network (PIRN), and completed by one representative per hospital. Site-level clinical management specific to each provider type was assessed. Data were analyzed descriptively. Results Of 59 individuals contacted, 43 responded (72.9%) of which 19 (44.2%) were community hospital paediatricians, 13 (30.2%) were children’s hospitals paediatricians, and 11 (25.6%) were paediatric ED physicians. Only one hospital had a comprehensive clinical practice guideline. The most frequently ordered tests in the ED were CBC (81.9%) and CRP (81.9%). Abnormal vision and painful extra-ocular movements were indicators for admission. For admitted children, CT scans were ordered ‘always or frequently’ by 46.2% of children’s hospital paediatricians and 5.3% of community hospital paediatricians. Ophthalmology (n=11, 84.6%), otolaryngology (n=9, 69.2%), and infectious diseases (n=6, 46.2%) were frequently consulted at children’s hospitals. Patients with periorbital cellulitis who did not require admission were usually discharged home on oral cephalexin. Table 1 outlines antibiotic selections for admitted patients. Conclusion There is no consensus on diagnostic test usage, subspeciality consultation, and empiric antibiotic therapy for severe orbital infections. A Canadian clinical practice guideline is needed to help standardize management.
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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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| 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".