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  1. Article: Moderate Pediatric Traumatic Brain Injury: What Is the Best Way Forward?

    Chong, Shu-Ling / Quek, Samuel Enci / Lee, Jan Hau

    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

    2022  Volume 23, Issue 6, Page(s) e300–e301

    MeSH term(s) Brain Injuries/therapy ; Brain Injuries, Traumatic/therapy ; Child ; Humans
    Language English
    Publishing date 2022-05-27
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2052349-X
    ISSN 1947-3893 ; 1529-7535
    ISSN (online) 1947-3893
    ISSN 1529-7535
    DOI 10.1097/PCC.0000000000002937
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  2. Article ; Online: Protocol for the diagnostic performance of C reactive protein, procalcitonin and interleukin-6 for serious bacterial infections among children ≤36 months old presenting with fever without source: a systematic review and meta-analysis.

    Sutiman, Natalia / Yao, Sarah Hui Wen / Goh, Sharon Si Min / Sultana, Rehena / Chong, Shu-Ling

    BMJ paediatrics open

    2024  Volume 8, Issue 1

    Abstract: Introduction: The management of fever without source in children ≤36 months old remains a diagnostic challenge as the underlying aetiologies can vary from self-limiting viral infections to serious bacterial infections (SBIs). Biomarkers such as C ... ...

    Abstract Introduction: The management of fever without source in children ≤36 months old remains a diagnostic challenge as the underlying aetiologies can vary from self-limiting viral infections to serious bacterial infections (SBIs). Biomarkers such as C reactive protein (CRP), procalcitonin (PCT) and interleukin-6 (IL-6) have varying thresholds in the prediction of SBIs due to differences in SBI definitions, SBI prevalence, patient characteristics and timing of presentation. This protocol describes a systematic review and meta-analysis that aims to determine the thresholds at which CRP, PCT and IL-6 can perform optimally in distinguishing the presence of SBIs in children ≤36 months old, as well as to determine their performances in early detection of bacterial infections within 48 hours of fever onset.
    Methods and analysis: We will systematically search electronic databases including MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane CENTRAL, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and Science Citation Index from 1 July 2023 to 31 July 2023. We will include studies that report the diagnostic accuracy of CRP, PCT and IL-6 in detecting SBIs in children aged ≤36 months presenting with fever without apparent source. Randomised controlled trials (RCTs) and non-randomised studies including non-RCTs and controlled before-and-after studies will be included. A meta-analysis will be performed and diagnostic performances of these biomarkers will be reported.
    Ethics and dissemination: The results of this study will provide guidance on clinical decision-making in young children presenting with fever without source. Ethics approval will not be required for this study. The authors aim to publish the findings in a peer-reviewed journal as well as present at international conferences.
    Prospero registration number: CRD42023439093.
    MeSH term(s) Child ; Humans ; Child, Preschool ; C-Reactive Protein/analysis ; Interleukin-6 ; Procalcitonin ; Calcitonin ; Calcitonin Gene-Related Peptide ; Protein Precursors ; Bacterial Infections/diagnosis ; Fever/etiology ; Fever/microbiology ; Biomarkers ; Meta-Analysis as Topic ; Systematic Reviews as Topic
    Chemical Substances C-Reactive Protein (9007-41-4) ; Interleukin-6 ; Procalcitonin ; Calcitonin (9007-12-9) ; Calcitonin Gene-Related Peptide (JHB2QIZ69Z) ; Protein Precursors ; Biomarkers
    Language English
    Publishing date 2024-03-18
    Publishing country England
    Document type Journal Article
    ISSN 2399-9772
    ISSN (online) 2399-9772
    DOI 10.1136/bmjpo-2023-002237
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  3. Article: Effective diagnosis of sepsis in critically ill children using probabilistic graphical model.

    Nguyen, Tuong Minh / Poh, Kim Leng / Chong, Shu-Ling / Lee, Jan Hau

    Translational pediatrics

    2023  Volume 12, Issue 4, Page(s) 538–551

    Abstract: Background: Probabilistic graphical model, a rich graphical framework in modelling associations between variables in complex domains, can be utilized to aid clinical diagnosis. However, its application in pediatric sepsis remains limited. This study ... ...

    Abstract Background: Probabilistic graphical model, a rich graphical framework in modelling associations between variables in complex domains, can be utilized to aid clinical diagnosis. However, its application in pediatric sepsis remains limited. This study aims to explore the utility of probabilistic graphical models in pediatric sepsis in the pediatric intensive care unit.
    Methods: We conducted a retrospective study on children using the first 24-hour clinical data of the intensive care unit admission from the Pediatric Intensive Care Dataset, 2010-2019. A probabilistic graphical model method, Tree Augmented Naive Bayes, was used to build diagnosis models using combinations of four categories: vital signs, clinical symptoms, laboratory, and microbiological tests. Variables were reviewed and selected by clinicians. Sepsis cases were identified with the discharged diagnosis of sepsis or suspected infection with the systemic inflammatory response syndrome. Performance was measured by the average sensitivity, specificity, accuracy, and area under the curve of ten-fold cross-validations.
    Results: We extracted 3,014 admissions [median age of 1.13 (interquartile range: 0.15-4.30) years old]. There were 134 (4.4%) and 2,880 (95.6%) sepsis and non-sepsis patients, respectively. All diagnosis models had high accuracy (0.92-0.96), specificity (0.95-0.99), and area under the curve (0.77-0.87). Sensitivity varied with different combinations of variables. The model that combined all four categories yielded the best performance [accuracy: 0.93 (95% confidence interval (CI): 0.916-0.936); sensitivity: 0.46 (95% CI: 0.376-0.550), specificity: 0.95 (95% CI: 0.940-0.956), area under the curve: 0.87 (95% CI: 0.826-0.906)]. Microbiological tests had low sensitivity (<0.10) with high incidence of negative results (67.2%).
    Conclusions: We demonstrated that the probabilistic graphical model is a feasible diagnostic tool for pediatric sepsis. Future studies using different datasets should be conducted to assess its utility to aid clinicians in the diagnosis of sepsis.
    Language English
    Publishing date 2023-04-04
    Publishing country China
    Document type Journal Article
    ZDB-ID 2901309-4
    ISSN 2224-4344 ; 2224-4344 ; 2224-4336
    ISSN (online) 2224-4344
    ISSN 2224-4344 ; 2224-4336
    DOI 10.21037/tp-22-510
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  4. Article ; Online: Pretriage criteria for identifying COVID-19-positive patients in the paediatric emergency department.

    Tan, Ronald Ming Ren / Ong, Gene Yong-Kwang / Chong, Shu-Ling / Soo, Jenifer Shui Lian / Ganapathy, Sashikumar / Tyebally, Arif / Lee, Khai Pin

    Singapore medical journal

    2023  

    Language English
    Publishing date 2023-08-14
    Publishing country India
    Document type Journal Article
    ZDB-ID 604319-7
    ISSN 2737-5935 ; 0037-5675
    ISSN (online) 2737-5935
    ISSN 0037-5675
    DOI 10.4103/singaporemedj.SMJ-2021-381
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  5. Article ; Online: Correction: Pyrexia in a young infant - is height of fever associated with serious bacterial infection?

    Tan, Victoria Shi Rui / Ong, Gene Yong-Kwang / Lee, Khai Pin / Ganapathy, Sashikumar / Chong, Shu-Ling

    BMC pediatrics

    2022  Volume 22, Issue 1, Page(s) 343

    Language English
    Publishing date 2022-06-15
    Publishing country England
    Document type Published Erratum
    ZDB-ID 2041342-7
    ISSN 1471-2431 ; 1471-2431
    ISSN (online) 1471-2431
    ISSN 1471-2431
    DOI 10.1186/s12887-022-03374-3
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  6. Article: Slowing down in the fast lane: could this be sinus tachycardia?

    Man, Shiu Yuen / Choo, Jonathan Tze Liang / Chong, Shu-Ling / Tan, Ronald Ming Ren

    Singapore medical journal

    2022  Volume 63, Issue 1, Page(s) 10–13

    MeSH term(s) Electrocardiography ; Humans ; Tachycardia, Sinus/diagnosis
    Language English
    Publishing date 2022-04-25
    Publishing country Singapore
    Document type Journal Article
    ZDB-ID 604319-7
    ISSN 0037-5675
    ISSN 0037-5675
    DOI 10.11622/smedj.2022024
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  7. Article: Advancing research in the exciting field of emergency medicine.

    Chong, Shu-Ling / Ong, Marcus Eng Hock

    Singapore medical journal

    2020  Volume 61, Issue 2, Page(s) 58–59

    MeSH term(s) Biomedical Research ; Emergency Medicine/methods ; Emergency Service, Hospital ; Humans ; Singapore ; Tertiary Care Centers ; Wounds and Injuries
    Language English
    Publishing date 2020-03-30
    Publishing country Singapore
    Document type Journal Article
    ZDB-ID 604319-7
    ISSN 0037-5675
    ISSN 0037-5675
    DOI 10.11622/smedj.2020012
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  8. Article ; Online: Association of postpartum depression with child growth and developmental outcomes: a community-based study.

    Chia, Moira Suyin / Ahmad Hatib, Nur Adila Binte / Chew, Elaine Chu Shan / Chong, Shu-Ling / Sultana, Rehena / Tan, Ade Xin Ning / Guo, Xiaoxuan / Ng, David Chee Chin / Yeleswarapu, Padmini Sita / Agarwal, Pratibha Keshav / Chen, Helen Yu / Chan, Yoke Hwee

    Singapore medical journal

    2024  

    Language English
    Publishing date 2024-03-13
    Publishing country India
    Document type Journal Article
    ZDB-ID 604319-7
    ISSN 2737-5935 ; 0037-5675
    ISSN (online) 2737-5935
    ISSN 0037-5675
    DOI 10.4103/singaporemedj.SMJ-2023-107
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  9. Article: The end of the road for early tracheal intubation in cardiac arrest?

    Chong, Shu-Ling / Lee, Jan Hau

    Journal of thoracic disease

    2017  Volume 9, Issue 4, Page(s) 976–978

    Language English
    Publishing date 2017-05-16
    Publishing country China
    Document type Editorial ; Comment
    ZDB-ID 2573571-8
    ISSN 2077-6624 ; 2072-1439
    ISSN (online) 2077-6624
    ISSN 2072-1439
    DOI 10.21037/jtd.2017.03.162
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  10. Article: Cost of inpatient rehabilitation for children with moderate to severe traumatic brain injury.

    Teo, Jia Hui / Chong, Shu-Ling / Chiang, L W / Ng, Zhi Min

    Annals of the Academy of Medicine, Singapore

    2021  Volume 50, Issue 1, Page(s) 26–32

    Abstract: Aim: To evaluate the cost of inpatient rehabilitation for children with moderate to severe traumatic brain injury (TBI). Secondary aim was to identify factors associated with high inpatient rehabilitation cost.: Method: Retrospective review of a ... ...

    Abstract Aim: To evaluate the cost of inpatient rehabilitation for children with moderate to severe traumatic brain injury (TBI). Secondary aim was to identify factors associated with high inpatient rehabilitation cost.
    Method: Retrospective review of a tertiary hospital's trauma registry was performed from 2011-2017. All patients aged 16 years or younger who sustained TBI with Glasgow Coma Scale ≤13 were included. Data on patient demographics, mechanism and severity of injury, hospital duration and inpatient rehabilitation cost were collected. We performed a regression analysis to identify factors associated with high rehabilitation cost.
    Results: There were a total of 51 patients. The median duration of inpatient rehabilitation was 13.5 days (interquartile range [IQR] 4-35), amounting to a median cost of SGD8,361 (IQR 3,543-25,232). Daily ward costs contributed the most to total inpatient rehabilitation cost. Those with severe TBI had longer duration of inpatient rehabilitation that resulted in higher cost of inpatient rehabilitation. Presence of polytrauma, medical complications, post-traumatic amnesia and TBI post-non-accidental injury (NAI) were associated with higher cost of inpatient rehabilitation.
    Conclusion: The cost of inpatient rehabilitation for paediatric patients post-TBI is significant in Singapore. Patients with TBI secondary to NAI had significantly higher cost of inpatient rehabilitation. Ways to reduce duration of hospitalisation post-TBI and early step-down care or outpatient rehabilitation should be explored to reduce cost.
    MeSH term(s) Brain Injuries, Traumatic/epidemiology ; Child ; Glasgow Coma Scale ; Humans ; Inpatients ; Retrospective Studies ; Singapore/epidemiology
    Language English
    Publishing date 2021-02-15
    Publishing country Singapore
    Document type Journal Article
    ZDB-ID 604527-3
    ISSN 0304-4602
    ISSN 0304-4602
    DOI 10.47102/annals-acadmedsg.2020114
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