Guide­lines to help doc­tors treat chil­dren

China Daily (Canada) - - CHINA - By ZHOU WENTING in Shang­hai zhouwent­ing@chi­

Top Chi­nese ex­perts in pe­di­atric medicine con­verged on Shang­hai this week to start work on com­pil­ing national guide­lines aimed at stan­dard­iz­ing the di­ag­no­sis and treat­ment of chil­dren’s ill­nesses and other health is­sues.

The panel, which in­cludes hos­pi­tal pres­i­dents, sur­geons and aca­demics, met for the first time at Fu­dan Univer­sity Chil­dren’s Hos­pi­tal on Tues­day and chose the first four top­ics for ad­vi­sories to be shared with doc­tors na­tion­wide.

Guide­lines on in­flam­ma­tory bowel dis­ease, pe­di­atric gas­troscopy pro­ce­dures, nu­tri­tional support for crit­i­cally ill chil­dren and gen­eral phys­i­cal ac­tiv­ity are ex­pected to be re­leased by the end of 2018, ac­cord­ing to Zhang Chong­fan, ed­i­to­rial di­rec­tor of the Chi­nese Jour­nal of Ev­i­dence­Based Pe­di­atrics and a mem­ber of the 41-strong panel.

Huang Guoy­ing, pres­i­dent of the hos­pi­tal, said a lack of national guide­lines has led to in­con­sis­tent qual­ity of treat­ment in China.

“It’s of­ten the case that 10 doc­tors will give 10 dif­fer­ent ideas about the di­ag­no­sis and treat­ment of a sick child, which con­fuses the pa­tient, par­ents and even the doc­tors,” he said. “The guide­lines are in­tended to en­sure that chil­dren re­ceive the same treat­ment at all hos­pi­tals, and that med­i­cal mis­takes can be avoided as much as pos­si­ble.”

The med­i­cal jour­nal, which is influential with the coun­try’s pe­di­a­tri­cians, is based at the hos­pi­tal and has pre­vi­ously seen some suc­cess in stan­dard­iz­ing doc­tors’ be­hav­ior.

Over the past seven years, it has pub­lished guide­lines on treat­ing fevers in chil­dren un­der age 5 and help­ing new­borns with hy­poxic is­chemic en­cephalopa­thy, or HIE, a con­di­tion that oc­curs when the brain doesn’t get suf­fi­cient oxy­gen.

“Be­fore, one hos­pi­tal might have a guide­line about a cer­tain dis­ease, but an­other hos­pi­tal might dis­agree. Now we’re try­ing to look for uni­ver­sal con­clu­sions based on the na­tion­wide data that has not been ob­tained be­fore,” Huang said.

For ex­am­ple, he said, if a child with pneu­mo­nia goes to see the doc­tor, the guide­lines will make clear which tests should be used for di­ag­no­sis, and, if the child shows cer­tain com­pli­ca­tions, which ad­di­tional tests should be done to find out why the child is sick.

“In the guide­line for HIE among new­borns, we stip­u­lated that doc­tors must re­duce the use of some medicines, which are un­nec­es­sary and could re­sult in the pa­tient’s par­ents hav­ing to pay higher med­i­cal bills,” said Yuan Lin, di­rec­tor of the Fu­dan hos­pi­tal’s ad­min­is­tra­tive of­fice. “Doc­tors al­ways want to see the best re­sults from their treat­ment and the best out­comes for the pa­tients, but this can some­times mean they pre­scribe un­nec­es­sary medicines.”

Zhang said the national guide­lines will be com­piled from analy­ses of ar­ti­cles in the jour­nal that re­ceived the best feed­back, re­search from hos­pi­tals na­tion­wide and in­ter­na­tional ad­vi­sories.

The expert panel was con­vened by the National Chil­dren’s Med­i­cal Cen­ter fol­low­ing a re­quest from the National Health and Fam­ily Plan­ning Com­mis­sion in April.

Huang, the hos­pi­tal pres­i­dent, said the goal is to even­tu­ally have guide­lines cov­er­ing more than 300 child­hood dis­eases and con­di­tions, with the ini­tial tar­get be­ing to re­lease five per year.

The guide­lines are in­tended to en­sure ... that med­i­cal mis­takes can be avoided as much as pos­si­ble.”


Gulls twist and turn over the Daguan River in Kun­ming, Yun­nan prov­ince, on Wed­nes­day. Ac­cord­ing to re­searchers, about 40,000 of the birds come to the city’s Dianchi Lake area ev­ery year from Siberia when the weather turns cold. They typ­i­cally start ar­riv­ing in early Oc­to­ber.

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