Field:

  • Emergency medicine
  • Paediatrics
  • Trauma and critical care

Location: Centre for Children's Health Research

Type of student: Volunteer/extra-curricular

Type of work: Chart review

Background Information
The Paediatric Research in Emergency Departments International Collaborative (PREDICT) have recently conducted “The Australian Paediatric Head Injury Rules Study” (APHIRST). This was a prospective observational study of children <18 years with head injuries of any severity, conducted at 10 Australian and New Zealand centres. The study included over 20,000 children with head injuries at Australian and New Zealand Emergency Departments to determine which overseas developed clinical decision rule (CDR) for computed tomography imaging of the head (CTB) should be used in Australian and New Zealand. The three CDRs are the i) Canadian Assessment of Tomography for Childhood Head injury (CATCH) developed in Canada; ii) Children’s Head injury Algorithm for the prediction of Important Clinical Events (CHALICE) developed in the UK; and iii) Pediatric Emergency Care Applied Research Network (PECARN) CDR developed in the USA.

Findings of the APHIRST study have recently been published in the Lancet and the next steps for the research group is to inform the knowledge translation (KT) strategy and to identify the areas of greatest improvement potential. The aims of this research are to i) determine the baseline CTB rate for a broad range of hospitals; ii) understand why there may be variations in CTB rates and iii) determine what resources are currently available and used by the ED community to inform their management of head injuries. This will help to determine the information needs of the broader ED community and will inform the content and format/methods by which to deliver KT strategies to improve the appropriateness of CTB in children with mild head injuries.

Objectives
1. Conduct a multi-centre medical records audit to:
a) Assess ED-level variation in the use of CT scanning of the brain (CTB) in the diagnosis of children with head injury in tertiary, urban, and rural/regional hospitals in Australia and NZ.
b) Identify potential hospital and/or patient level factors associated with CTB use.
2. Conduct qualitative research to:
a) Identify and explore the clinician and organisational related factors influencing the use of CTB at participating EDs in children with mild head injuries.
b) Determine the resources available and used by clinicians in the ED to inform their management of mild head injuries; through qualitative research.

The Paediatric Emergency Research Unit (PERU)are seeking support from a medical student/s to work on this project, predominantly assisting with the medical record audit. Full support will be provided including training in RedCAP database entry. This is a fantastic opportunity to work on this international research project and learn valuable research skills which are transferrable for all future research work.

Prerequisite skills: None, required full training will be provided

Time frame: November 2017 - February 2018

Websitehttp://www.predict.org.au/projects/aphirst-gap/

Supervisor

Dr Natalie Phillips

Medical Lead Paediatric Emergency Research Unit (PERU)
Lady Cilento Children's Hospital