I have a particular interest and expertise in paediatric neuromuscular diseases and childhood MS and I run both paediatric services in East Anglia. Early developmental disorders (EDI) are common and have many etiologies and therefore potential investigations. There are several published guidelines that recommend etiological examinations, and pediatricians` opinions about them vary. Little is known about the thought processes underlying clinical decisions in the EDI study. This study aimed to describe the thought processes that influence clinical decisions regarding the study of EDI in a nationalized health system. He is an expert in the diagnosis and management of functional somatic and neurological disorders such as chronic fatigue and chronic pain syndromes, which lie at the intersection of general medicine, surgery and psychiatry. He is frequently responsible for providing medical advice on psychiatric disorders, head injuries and post-concussion syndromes. Dr. Bourke is a Clinical Senior Lecturer in Neurophysiology and Clinical Psychiatry at Queen Mary University of London. His research focuses on the neurophysiology of chronic pain, somatic syndromes and stress-related disorders. We provide forensic reports for lawyers and immediate needs analyses for case managers. My professional interests and expertise in pediatric neurology lie in the neurorehabilitation of children with acute and early acquired brain injury, particularly in the treatment of increased muscle tone (spasticity and dystonia). I regularly interact with a variety of professionals from various therapeutic disciplines, educational and social institutions to provide multidisciplinary care to children with cerebral palsy, head injuries, strokes, meningitis, and brain tumors.
„Caution” is the practice of avoiding risks and paying attention to one`s own behavior. In the context of this study, it was a question of requiring a large number of tests to ensure that no etiology was missed. Participants described both their own practice and that of other clinicians, in which a large number of tests were ordered without reference to clinical features or likelihood of diagnosis. In some cases, this has been motivated by computerized surveys, where a predetermined series of investigations has been ordered. In this sub-theme, guidelines and standardization of practice between colleagues and centres were highly appreciated, providing protection against medico-legal claims and criticism when a diagnosis was missed. As a pediatrician, I assess children up to the age of 16. I started my forensic work in 2013, so I prepare forensic reports with a lot of experience for a long time. I also testified in court and did a neurological report. The innovative technologies used by our experts offer advanced sophistication in the assessment and ongoing treatment of medico-legal cases. For example, using the latest 3T MRI technology and neuroradiological expertise, our experts solved several cases where previous brain imaging could not detect brain injury. A qualitative descriptive study with semi-structured qualitative interviews conducted in person or via video link with paediatricians who see children with EDI in England. As part of the interview, participants were given a case study of a fictional disease, cavorite deficiency, modeled on biotinidase deficiency, with testing cost, incidence, and likelihood of responding to treatment.
This allowed costs to be determined without burdening predisposing views and training on the condition. The thematic analysis was carried out by iterative approach. When participants indicated that they wanted to divert money from surveys to treatments, if possible, we asked them what services they would like to have better funded in their area. Only one interviewer conducted the semi-structured (MA) interviews. The interviewer was a senior male trainee in pediatric neurology close to the counselling level who was pursuing a master`s degree in child health. The number of paediatric neurology counsellors and trainees is low in the UK, so the interviewer may have previously known or worked with the interviewee. The interviewer had previously published in EDI and may have had preconceived ideas that led to bias. We reduced this risk by ensuring that the thematic guide contained open-ended questions that did not lead and by providing training on how to conduct interviews. Interviews were conducted at a time and location chosen by participants and, if possible, conducted 1:1. When the COVID-19 pandemic began, interviews were conducted virtually via video link.
A written declaration of consent was obtained from all participants. I am a consultant pediatric neurologist with 17 years of experience in pediatrics and the last 10 years in pediatric neurology full-time. I deal with the diagnosis and treatment of children with acute and chronic neurological diseases, both common and rare. These include: cerebral palsy, spasticity and movement disorders, epilepsy, headaches, neurogenetic diseases, and neurological sleep disorders. Hello, Dr AC Consultant paediatric neurologist in Cheshire here. I am one of the consultant pediatric neurologists who work closely with the legal team to produce high quality forensic reports on childhood injuries.