Daniela Choukair, Christian Patry, Ronny Lehmann, Dorothea Treiber, Georg F Hoffmann, Corinna Grasemann, Normi Bruck, Reinhard Berner, Peter Burgard, Hanns-Martin Lorenz, Burkhard Tönshoff
Resource utilization and costs of transitioning from pediatric to adult care for patients with chronic autoinflammatory and autoimmune disorders
Pediatric rheumatology online journal
sudden cardiac death children rare event great social significance generally related heart disease risk sudden cardiac death scd may occur cardiovascular symptoms andor electrocardiographic markers thus primary care paediatrician pcp could detect therefore proposed study assesses put practice conduct cardiovascular assessment within routine healthychild checkups six twelve years age reflects cardiovascular signs symptoms well electrocardiographic alterations children risk scd selected population present assesses pcps skill electrocardiogram ecg interpretation collaboration pcps primary care nurses paediatric cardiologists observational descriptive multicentre crosssectional study carried balearic islands spain april 2021 january 2022 inclusive pcps gathered patient data forms medical record electrocardiogram physical examination sent investigator together informed consent document electrocardiogram investigator passed electrocardiogram paediatric cardiologists reading identical form paediatricians filled variables collected descriptive analysis performed three paediatric cardiologists twelve pcps nine nurses seven public health centres took part collected data 641 patients 233 patients participate 8111 due pcps workload therefore study coverage around 64 representing quotient total number patients participated divided total number patients eligible study detected 30 patients electrocardiographic alterations compatible scd risk nine examined paediatric cardiologist time functional murmur 89 five reported shortness breath exercise four reported family history sudden death physical examination patients whose ecg compatible risk scd normal upon analysing extent ecg results pcp paediatric cardiologist agreed percentage agreement final interpretation normalaltered 919 cohens kappa coefficient 312 ci 95 138486 sensitivity ecg interpretation pcp detect ecg compatible risk scd 29 positive predictive value 45 conclusions study lays foundations future scd risk screening children performed pcps however previously would important optimise training reading interpreting paediatric ecgs known spain present programme place detect heart disease risk sudden death 1 targets children starting physical activity federated sport implementing screening programmes proven effective several countries 2 however several studies showed incidence sudden cardiac death higher children competing sport activities sport 3 poses ethical conflict present children federated sport excluded screening according revised literature far two studies screen child population schools successfully detected patients heart disease associated risk sudden death 4 5 found studies screening features included within routine healthychild checkups primary care paediatricians new know whetherin setting presentthe primary care paediatrician could perform screening method within routine healthychild checkups order detect presumably healthy children risk sudden cardiac death present one scd risks regard proposed project assess put practice conduct cardiovascular assessment via scd risk screening healthy child population primary care paediatricians appraise primary care paediatricians skills identifying electrocardiographic alterations associated scd risk ultimate intention pilot study make possible future design justify study aimed universalising cardiovascular screening achieving longterm decrease sudden cardiac death events children