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Application of diagnostic criteria in paediatric complex regional pain syndrome: a scoping review protocol

Por: Tham · S. W. · Lee · R. · Rau · L.-M. · Sethna · N. F. · Nylander · E. M. · Fabrizi · L. · Wager · J. · Koechlin · H.
Introduction

There are no validated paediatric-specific diagnostic criteria for complex regional pain syndrome (CRPS). As a result, diagnostic tools developed for adults (eg, Budapest Criteria, Japanese Diagnostic Criteria, Veldman Criteria) are frequently applied in the paediatric population. However, the clinical presentations and trajectories of children can differ from adults. Given that treatment outcomes are linked to early diagnosis and intervention, the lack of paediatric-specific screening or diagnostic tools is an important knowledge gap. We aim to identify the frequency of individual criteria used in diagnosing CRPS in children and adolescents in existing literature, summarise assessment methods used to establish the diagnosis, and provide recommendations for research and clinical application.

Methods

The following databases and platforms will be searched for articles published from 2003 (year the Budapest Criteria was developed) onward: CINAHL, CENTRAL, Embase, Ovid MEDLINE, PubMed, PsycINFO and Web of Science. Our search strategy will use subject headings and text words related to the concepts of CRPS in paediatric populations, with study inclusion criteria from birth up to 18 years old, and a diagnosis of CRPS. Data will be extracted by our multidisciplinary team and findings will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

Ethics and dissemination

This study does not involve human participants or unpublished data; therefore, approval from a human research ethics committee is not required. The findings of this scoping review will be disseminated through academic conferences and peer-reviewed publications.

Urinary cotinine cut-off concentrations in children under 5 years for assessing environmental tobacco smoke exposure: a systematic review and meta-analysis protocol

Por: Sayed Mohamed Zain · S. M. · Abdul Shukor · I. H. · Mohamad · N. · Wan Azmi · W. N. F. · Anual · Z. F.
Introduction

Environmental tobacco smoke (ETS) is generally known as secondhand smoke. Assessing the magnitude of children’s exposure to ETS from early infancy is essential for public health and research endeavours. Urinary cotinine is now widely recognised as the primary indicator for assessing exposure to ETS across all age groups. This systematic review and meta-analysis aim to synthesise all the published evidence on the urinary cotinine cut-off concentrations used to categorise children under 5 years as being exposed to ETS.

Methods and analysis

We will conduct a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A comprehensive search will be conducted from various databases including PubMed, EMBASE, Scopus and Cochrane Library. This search will be performed from the earliest published articles up to the latest available studies until February 2025. We will include all the experimental and observational studies, such as cohort, case–control and cross-sectional, that measure urinary cotinine concentrations in children under 5 years old. Data extraction will be conducted using a standardised data extraction form, and the study quality will be evaluated according to the guidelines specified by the Newcastle-Ottawa Scale. The extracted data will be pooled and combined for meta-analysis. Two reviewers will independently screen, select and assess the quality of the included study. The result will be tabulated in a table of characteristics of the included study, which consists of the cut-off cotinine concentrations, analytical technique, method referred, study design, study area and respondents’ characteristics.

Ethics and dissemination

Ethics approval is not required as this is a review of collected published data. Findings will be disseminated in peer-reviewed publications and conference presentations, as well as with key stakeholders, health policymakers and healthcare professionals.

PROSPERO registration number

CRD42024556969.

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