APHIRST

APHIRST- Gap

APHIRST- Gap Australian Paediatric Head Injury Rules Study: Assessing the gap prior to implementation

This multicenter study has two primary aims; (1) we will assess Emergency Department-level variation in the use of CT scanning of the brain (CTB) in the diagnosis of children with mild head injury in tertiary, urban, and rural/regional hospitals in Australia and NZ, and identify potential hospital and/or patient level factors associated with CTB use; (2) we will identify and explore the clinician and organisational related factors influencing the use of CTB at participating Emergency Departments in children with head injuries and determine resource availability and need.

Each site will conduct a medical record audit to extract data relating to children who have presented with a head injury to the emergency department in 2016. Data will be extracted using a case report and entered into a web-based database.  Qualitative semi-structured interviews will be conducted with invited doctors and nurses who treat children in the participating EDs, via telephone using a semi-structured interview proforma based on the Theoretical Domains Framework.

Study design

Retrospective observational study with Qualitative component.

Completed

Respiratory

Franz Babl

Time frame

2016 – 2018

Funding

National Health and Medical Research Council (ID 1058560)
Angior Family Foundation
Emergency Medicine Foundation
Royal Children’s Hospital Foundation


  • Royal Children’s Hospital, Melbourne, Australia
  • Angliss Hospital, Upper Ferntree Gully,Victoria, Australia
  • Bendigo Hospital, Bendigo, Victoria, Australia
  • Box Hill Hospital, Box Hill, Victoria, Australia
  • Maroondah Hospital, Ringwood East, Victoria, Australia
  • Monash Children’s Hospital, Clayton, Victoria, Australia
  • Canberra Hospital, Canberra, ACT, Australia
  • Coffs Harbour Base Hospital, Coffs Harbour, NSW, Australia
  • Mt Druitt Hospital, Mt Druitt, NSW, Australia
  • Sutherland Hospital, Caringbah, NSW, Australia
  • Sydney Children’s Hospital, Randwick, NSW, Australia
  • Tamworth Hospital, Tamworth, NSW, Australia
  • Westmead Children’s Hospital, Westmead, NSW, Australia
  • Bundaberg Hospital, Bundaberg, QLD, Australia
  • Caloundra Hospital, Caloundra, QLD, Australia
  • Gold Coast University Hospital, Southport, QLD, Australia
  • Ipswich Hospital, Ipswich, QLD, Australia
  • Lady Cilento Children’s Hospital, Brisbane, QLD, Australia
  • Logan Hospital, Logan, QLD, Australia
  • Nambour Hospital, Nambour, QLD, Australia
  • Prince Charles Hospital, Chermside, QLD, Australia
  • Robina Hospital, Robina, QLD, Australia
  • Toowoomba Hospital, Toowoomba, QLD, Australia
  • Port Augusta Hospital, Port Augusta, SA, Australia
  • Women’s and Children’s Hospital, Adelaide, SA, Australia
  • Albany Regional Hospital, Albany, WA, Australia
  • Armadale Kelmscott, District Memorial Hospital, Mt Nasura, WA, Australia
  • Bunbury Regional Hospital, Bunbury, WA, Australia
  • Perth Children’s Hospital, Perth, WA, Australia
  • Starship Hospital, Auckland, New Zealand
  • Tauranga Hospital, Tauranga, New Zealand
  • Waikato Hospital, Waikato, New Zealand

Sample

3,200 records of children aged 0 – 16 years, diagnosed with head injury
40 semi-structured interviews with ED nursing and medical staff

Contact

franz.babl@rch.org.au

Publications to date

 

 

 

Wilson CL, Tavender EJ, Phillips NT, Hearps SJ, Foster K, O’Brien SL, Borland ML, Watkins GO, McLeod L, Putland M, Priestley S, Brabyn C, Ballard DW, Craig S, Dalziel SR, Oakley E, Babl FE; PREDICT. Variation in CT use for paediatric head injuries across different types of emergency departments in Australia and New Zealand. Emerg Med J. 2020 Nov;37(11):686-689. doi: 10.1136/emermed-2020-209719. Epub 2020 Aug 17. PMID: 32816840. [link]

Wilson CL, Hearps SJ, Tavender EJ, Phillips NT, Lawton B, Kinnear F, Beattie A, Mitenko H, Young R, Cole J, Kochar A, George S, Teo SS, Georgeson T, Michael A, Mukherjee A, King A, Gamage L, Archer P, Cassidy C, Rao A, Thosar D, Borland ML, Babl FE. Factors predictive for computed tomography use and abnormality in paediatric head injuries in Australia and New Zealand. Emerg Med Australas. 2021 Feb;33(1):157-160. doi: 10.1111/1742-6723.13694. Epub 2020 Dec 22. PMID: 33354919. [link]

Shavit I, Rimon A, Waisman Y, Borland ML, Phillips N, Kochar A, Cheek JA, Gilhotra Y, Furyk J, Neutze J, Dalziel SR, Lyttle MD, Bressan S, Donath S, Hearps S, Oakley E, Crowe L, Babl FE; (PREDICT). Performance of Two Head Injury Decision Rules Evaluated on an External Cohort of 18,913 Children. J Surg Res. 2019 Aug 20;245:426-433. doi: 10.1016/j.jss.2019.07.090. [Epub ahead of print] [link]

Babl FE, Cheek J, Dalziel K, Bressan S, Dalziel S. on behalf of PREDICT. In Reply to Mower LTE 2019-864: Clinical Judgment and the Clinical Decision Rules. Annals Emergency Medicine. Dec 2019; 74(6): 821-823. https://doi.org/10.1016/j.annemergmed.2019.06.006. [Epub ahead of print] [link].

Babl FE, Oakley E, Dalziel SR, Borland ML, Phillips N, Kochar A, Dalton S, Cheek JA, Gilhotra Y, Furyk J, Neutze J, Donath S, Hearps S, Crowe LM, Arpone M, Bressan S, Lyttle MD; (PREDICT). Accuracy of NEXUS II head injury decision rule in children: a prospective PREDICT cohort study, Emerg Med J. 2018 Aug 20. pii: emermed-2017-207435. doi: 10.1136/emermed-2017-207435. [Epub ahead of print] PMID: 30144871 [link]

Dalziel K, Cheek JA, Fanning L, Borland ML, Phillips N, Kochar A, Dalton S, Furyk J, Neutze J, Dalziel SR, Lyttle MD, Bressan S, Donath S, Molesworth C, Hearps SJC, Oakley E, Babl FE; (PREDICT). A Cost-Effectiveness Analysis Comparing Clinical Decision Rules PECARN, CATCH, and CHALICE With Usual Care for the Management of Pediatric Head Injury. Ann Emerg Med. 2018 Nov 14. doi: 10.1016/j.annemergmed.2018.09.030. [Epub ahead of print] [link]