Psychological outcomes in paediatric major trauma patients who require invasive management: protocol for a systematic review and meta-analysis
Introduction Paediatric major trauma patients with more severe injuries and physiological or biochemical abnormalities as a result of the injury are more likely to require invasive management in the form of an operation/interventional radiology (IR). Adverse psychological outcomes, such as post-trau...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2025-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/8/e101971.full |
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| author | Stephen H Thomas Veronica Phillips Owen Hibberd Spyridon Karageorgos Caroline E Thomas Sarah Gentle Sandi Angus |
| author_facet | Stephen H Thomas Veronica Phillips Owen Hibberd Spyridon Karageorgos Caroline E Thomas Sarah Gentle Sandi Angus |
| author_sort | Stephen H Thomas |
| collection | DOAJ |
| description | Introduction Paediatric major trauma patients with more severe injuries and physiological or biochemical abnormalities as a result of the injury are more likely to require invasive management in the form of an operation/interventional radiology (IR). Adverse psychological outcomes, such as post-traumatic stress disorder, anxiety, depression and adjustment disorder, are frequently observed in paediatric patients with major trauma. Similarly, it is recognised that children and adolescents who have invasive management are also at an increased risk of adverse psychological outcomes. However, it is not known to what extent major trauma patients requiring invasive management are at risk of adverse psychological outcomes compared with those managed conservatively. This study aims to determine whether paediatric major trauma patients who require an operation/IR have increased odds of having an adverse psychological outcome compared with those who are managed conservatively.Methods and analysis The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines will be used to construct this review. The databases Medline (via Ovid), Embase (via Ovid), PsycInfo (via Ebscohost) and Cinahl (via Ebscohost) will be searched from inception to February 2025. Both title and abstract screening and full-text screening will be done by two reviewers, with an adjudicating third reviewer. For randomised controlled trials, the Cochrane Risk of Bias Tool will be employed, while for non-randomised studies, the Newcastle-Ottawa Quality Assessment Scale will be used. We will assess bias using contoured funnel plots (with p set at 0.01, 0.05 and 0.10), non-parametric trim-fill analysis, leave-one-out analysis and Galbraith plotting. We will execute formal (Egger) testing for funnel plot asymmetry and also calculate prediction intervals if sufficient study N of 10 is accrued. Certainty and confidence in cumulative evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.Ethics and dissemination Ethical review is not required as no original data will be collected. Results will be disseminated through peer-reviewed publications and at academic conferences.PROSPERO registration number CRD42025643459. |
| format | Article |
| id | doaj-art-c5e4e682d2494965b426c710f8a124ca |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-c5e4e682d2494965b426c710f8a124ca2025-08-20T06:00:13ZengBMJ Publishing GroupBMJ Open2044-60552025-08-0115810.1136/bmjopen-2025-101971Psychological outcomes in paediatric major trauma patients who require invasive management: protocol for a systematic review and meta-analysisStephen H Thomas0Veronica Phillips1Owen Hibberd2Spyridon Karageorgos3Caroline E Thomas4Sarah Gentle5Sandi Angus62 Blizard Institute, Queen Mary University of London, London, UK5 University of Cambridge Medical Library, Cambridge, UK1 Emergency and Urgent Care Research in Cambridge (EURECA), PACE Section, Department of Medicine, Cambridge University, Cambridge, UK2 Blizard Institute, Queen Mary University of London, London, UK3 Georgetown University, Washington, Washington, DC, USA2 Blizard Institute, Queen Mary University of London, London, UK2 Blizard Institute, Queen Mary University of London, London, UKIntroduction Paediatric major trauma patients with more severe injuries and physiological or biochemical abnormalities as a result of the injury are more likely to require invasive management in the form of an operation/interventional radiology (IR). Adverse psychological outcomes, such as post-traumatic stress disorder, anxiety, depression and adjustment disorder, are frequently observed in paediatric patients with major trauma. Similarly, it is recognised that children and adolescents who have invasive management are also at an increased risk of adverse psychological outcomes. However, it is not known to what extent major trauma patients requiring invasive management are at risk of adverse psychological outcomes compared with those managed conservatively. This study aims to determine whether paediatric major trauma patients who require an operation/IR have increased odds of having an adverse psychological outcome compared with those who are managed conservatively.Methods and analysis The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines will be used to construct this review. The databases Medline (via Ovid), Embase (via Ovid), PsycInfo (via Ebscohost) and Cinahl (via Ebscohost) will be searched from inception to February 2025. Both title and abstract screening and full-text screening will be done by two reviewers, with an adjudicating third reviewer. For randomised controlled trials, the Cochrane Risk of Bias Tool will be employed, while for non-randomised studies, the Newcastle-Ottawa Quality Assessment Scale will be used. We will assess bias using contoured funnel plots (with p set at 0.01, 0.05 and 0.10), non-parametric trim-fill analysis, leave-one-out analysis and Galbraith plotting. We will execute formal (Egger) testing for funnel plot asymmetry and also calculate prediction intervals if sufficient study N of 10 is accrued. Certainty and confidence in cumulative evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.Ethics and dissemination Ethical review is not required as no original data will be collected. Results will be disseminated through peer-reviewed publications and at academic conferences.PROSPERO registration number CRD42025643459.https://bmjopen.bmj.com/content/15/8/e101971.full |
| spellingShingle | Stephen H Thomas Veronica Phillips Owen Hibberd Spyridon Karageorgos Caroline E Thomas Sarah Gentle Sandi Angus Psychological outcomes in paediatric major trauma patients who require invasive management: protocol for a systematic review and meta-analysis BMJ Open |
| title | Psychological outcomes in paediatric major trauma patients who require invasive management: protocol for a systematic review and meta-analysis |
| title_full | Psychological outcomes in paediatric major trauma patients who require invasive management: protocol for a systematic review and meta-analysis |
| title_fullStr | Psychological outcomes in paediatric major trauma patients who require invasive management: protocol for a systematic review and meta-analysis |
| title_full_unstemmed | Psychological outcomes in paediatric major trauma patients who require invasive management: protocol for a systematic review and meta-analysis |
| title_short | Psychological outcomes in paediatric major trauma patients who require invasive management: protocol for a systematic review and meta-analysis |
| title_sort | psychological outcomes in paediatric major trauma patients who require invasive management protocol for a systematic review and meta analysis |
| url | https://bmjopen.bmj.com/content/15/8/e101971.full |
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