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<meta name="citation_keywords" content="Meningococcal Infections">
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stroke-linecap="round" style="fill:#FFF" d="m320,350a153,153 0 1,0-2,2l170,170m-91-117 110,110-26,26-110-110"></path></svg></a><a id="jr-fip-done" class="wsprkl btn" title="Dismiss find">✘</a></nav><nav id="jr-fip-info-p"><a id="jr-fip-prev" class="wsprkl btn" title="Jump to previuos match">◀</a><button id="jr-fip-matches">no matches yet</button><a id="jr-fip-next" class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style"><div class="fm-sec bkr_bottom_sep"><div class="bkr_thumb"><a href="https://www.nice.org.uk" title="National Institute for Health and Care Excellence (NICE)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-niceng195er11-lrg.png" alt="Cover of Evidence review on support for confirmed bacterial meningitis" /></a></div><div class="bkr_bib"><h1 id="_NBK604232_"><span itemprop="name">Evidence review on support for confirmed bacterial meningitis</span></h1><div class="subtitle">Neonatal infection: antibiotics for prevention and treatment</div><p><b>Evidence review K</b></p><p><i>NICE Guideline, No. 195</i></p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2024 Mar</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-5801-6</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2024.</div></div><div class="bkr_clear"></div></div><div id="niceng195er11.s1"><h2 id="_niceng195er11_s1_">Support for confirmed bacterial meningitis or meningococcal disease</h2><div id="niceng195er11.s1.1"><h3>Review question</h3><p>What support is valued by patients with confirmed bacterial meningitis or meningococcal disease, and their families or carers?</p><div id="niceng195er11.s1.1.1"><h4>Introduction</h4><p>Bacterial meningitis and meningococcal disease (meningococcal sepsis with or without an associated meningitis) are rare but serious infections, which can occur in any age group.</p><p>When a diagnosis of bacterial meningitis or meningococcal disease is confirmed, patients and their families or carers will naturally have many concerns and questions.</p><p>The aim of this review is to determine what support patients and their families or carers value when a diagnosis of bacterial meningitis or meningococcal disease is confirmed.</p></div><div id="niceng195er11.s1.1.2"><h4>Summary of the protocol</h4><p>See <a href="/books/NBK604232/table/niceng195er11.tab1/?report=objectonly" target="object" rid-ob="figobniceng195er11tab1">Table 1</a> for a summary of the Population, Phenomenon of Interest and Context (PPC) characteristics of this review.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng195er11tab1"><a href="/books/NBK604232/table/niceng195er11.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img" rid-ob="figobniceng195er11tab1"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng195er11.tab1"><a href="/books/NBK604232/table/niceng195er11.tab1/?report=objectonly" target="object" rid-ob="figobniceng195er11tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">Summary of the protocol (PPC table). </p></div></div><p>For further details see the review protocol in <a href="#niceng195er11.appa">appendix A</a>.</p></div><div id="niceng195er11.s1.1.3"><h4>Methods and process</h4><p>This evidence review was developed using the methods and process described in <a href="https://www.nice.org.uk/process/pmg20/chapter/introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>. Methods specific to this review question are described in the review protocol in <a href="#niceng195er11.appa">appendix A</a> and the <a href="https://www.nice.org.uk/Guidance/ng240/evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">methods document for the NICE guideline on bacterial meningitis and meningococcal disease</a>.</p><p>Declarations of interest were recorded according to <a href="https://www.nice.org.uk/about/who-we-are/policies-and-procedures" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE’s conflicts of interest policy</a>.</p></div><div id="niceng195er11.s1.1.4"><h4>Qualitative evidence</h4><div id="niceng195er11.s1.1.4.1"><h5>Included studies</h5><p>Four studies were included in this review, 2 mixed-methods studies (<a class="bibr" href="#niceng195er11.s1.ref1" rid="niceng195er11.s1.ref1">Clark 2013</a>, <a class="bibr" href="#niceng195er11.s1.ref4" rid="niceng195er11.s1.ref4">Wisemantel 2018</a>), and 2 qualitative studies (<a class="bibr" href="#niceng195er11.s1.ref2" rid="niceng195er11.s1.ref2">Haines 2005</a>, <a class="bibr" href="#niceng195er11.s1.ref3" rid="niceng195er11.s1.ref3">Sweeney 2013</a>).</p><p>The included studies are summarised in <a href="/books/NBK604232/table/niceng195er11.tab2/?report=objectonly" target="object" rid-ob="figobniceng195er11tab2">Table 2</a>.</p><p>All studies reported the views and experiences of parents or carers of babies, children, and young people with confirmed bacterial meningitis or meningococcal disease.</p><p>The data from the included studies were synthesised and a number of central themes and sub-themes emerged (as shown in <a class="figpopup" href="/books/NBK604232/figure/niceng195er11.fig1/?report=objectonly" target="object" rid-figpopup="figniceng195er11fig1" rid-ob="figobniceng195er11fig1">Figure 1</a>).</p><p>One study was from the UK and Ireland (<a class="bibr" href="#niceng195er11.s1.ref1" rid="niceng195er11.s1.ref1">Clark 2013</a>), 1 study was from England (<a class="bibr" href="#niceng195er11.s1.ref2" rid="niceng195er11.s1.ref2">Haines 2005</a>), 1 study was from the UK (<a class="bibr" href="#niceng195er11.s1.ref3" rid="niceng195er11.s1.ref3">Sweeney 2013</a>), and 1 study was from Australia (<a class="bibr" href="#niceng195er11.s1.ref4" rid="niceng195er11.s1.ref4">Wisemantel 2018</a>).</p><p>See the literature search strategy in <a href="#niceng195er11.appb">appendix B</a> and study selection flow chart in <a href="#niceng195er11.appc">appendix C</a>.</p></div><div id="niceng195er11.s1.1.4.2"><h5>Excluded studies</h5><p>Studies not included in this review are listed, and reasons for their exclusion are provided in <a href="#niceng195er11.appj">appendix J</a>.</p></div></div><div id="niceng195er11.s1.1.5"><h4>Summary of included studies</h4><p>Summaries of the studies that were included in this review are presented in <a href="/books/NBK604232/table/niceng195er11.tab2/?report=objectonly" target="object" rid-ob="figobniceng195er11tab2">Table 2</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng195er11tab2"><a href="/books/NBK604232/table/niceng195er11.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img" rid-ob="figobniceng195er11tab2"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng195er11.tab2"><a href="/books/NBK604232/table/niceng195er11.tab2/?report=objectonly" target="object" rid-ob="figobniceng195er11tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of included studies. </p></div></div><p>See the full evidence tables in <a href="#niceng195er11.appd">appendix D</a>.</p><p>This was a qualitative meta-synthesis, so no quantitative meta-analysis was conducted (and there are no forest plots in <a href="#niceng195er11.appe">appendix E</a>).</p></div><div id="niceng195er11.s1.1.6"><h4>Summary of the evidence</h4><p>The evidence generated 4 main themes in relation to the support valued by parents, their families and carers when bacterial meningitis or meningococcal disease is confirmed. Three studies provided the evidence relating to need for support, which had 3 subthemes (diagnosis, during hospitalisation and post-discharge from hospital). Three studies provided the evidence relating to access to support, which had 3 subthemes (navigating the system, educational and developmental). Three studies provided the evidence relating to source of support, which had 6 subthemes (parents, medical staff, nursing staff, friends and family, counselling and public health bodies). Two studies provided the evidence relating to type of support, which had 3 subthemes (individualised to child, practical and reassurance). The overarching themes and subthemes were developed to allow subthemes on a common topic to be grouped to aid presentation of results, without obscuring the detail included within the individual subthemes. For example, the subthemes on source of support all related to different sources of support that parents and carers had reported using and what their views about these different sources were. The theme map (<a class="figpopup" href="/books/NBK604232/figure/niceng195er11.fig1/?report=objectonly" target="object" rid-figpopup="figniceng195er11fig1" rid-ob="figobniceng195er11fig1">Figure 1</a>) illustrates these overarching themes and related subthemes.</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figniceng195er11fig1" co-legend-rid="figlgndniceng195er11fig1"><a href="/books/NBK604232/figure/niceng195er11.fig1/?report=objectonly" target="object" title="Figure 1" class="img_link icnblk_img figpopup" rid-figpopup="figniceng195er11fig1" rid-ob="figobniceng195er11fig1"><img class="small-thumb" src="/books/NBK604232/bin/niceng195er11f1.gif" src-large="/books/NBK604232/bin/niceng195er11f1.jpg" alt="Figure 1. Theme map." /></a><div class="icnblk_cntnt" id="figlgndniceng195er11fig1"><h4 id="niceng195er11.fig1"><a href="/books/NBK604232/figure/niceng195er11.fig1/?report=objectonly" target="object" rid-ob="figobniceng195er11fig1">Figure 1</a></h4><p class="float-caption no_bottom_margin">Theme map. BM: Bacterial Meningitis; MD: Meningococcal disease + = moderate quality evidence; - = low quality evidence; -- = very low quality evidence</p></div></div><p>Whilst there was not a specific theme or subtheme about availability of support, the evidence on the theme about source of support was identified. No evidence emerged relevant to the theme of timing of support, that was included as a phenomenon of interest in the protocol.</p><p>A summary of the strength of evidence, assessed using GRADE-CERQual, is presented according to the themes in the theme map above. The main reasons for downgrading were due to concerns about the methodological limitations of the primary studies (for example, because of a lack of consideration of the relationship between researcher and participants, no justification for data collection methods as it relates to data saturation and potential for recruitment bias), concerns about relevance (for example, because studies restricted the population to meningococcal disease, thereby under-representing less severe forms of the disease), and concerns about adequacy (for example, for review findings when evidence offered no or only some or moderately rich data).</p><p>Findings from the studies are summarised in GRADE-CERQual tables. See the evidence profiles in <a href="#niceng195er11.appf">appendix F</a> for details.</p></div><div id="niceng195er11.s1.1.7"><h4>Economic evidence</h4><div id="niceng195er11.s1.1.7.1"><h5>Included studies</h5><p>A single economic search was undertaken for all topics included in the scope of this guideline, but no economic studies were identified which were applicable to this review question.</p></div></div><div id="niceng195er11.s1.1.8"><h4>Economic model</h4><p>No economic modelling was undertaken for this review because the committee agreed that other topics were higher priorities for economic evaluation. This was because this review does not involve a comparison of competing courses of action.</p></div><div id="niceng195er11.s1.1.9"><h4>The committee’s discussion and interpretation of the evidence</h4><div id="niceng195er11.s1.1.9.1"><h5>The outcomes that matter most</h5><p>The review focused on the views and experiences of the support provided when bacterial meningitis or meningococcal disease is confirmed. The committee identified a number of potential themes as illustrative of the main themes to guide the review. These themes were type of support, timing of support, and availability of support. However, the potential themes were not exhaustive, as the committee did not want to constrain the evidence, and an emergent approach was taken to the thematic synthesis.</p></div><div id="niceng195er11.s1.1.9.2"><h5>The quality of the evidence</h5><p>The evidence was assessed using GRADE-CERQual methodology and the overall confidence in the findings ranged from very low to moderate. Assessments of the potential methodological limitations of the primary studies were undertaken using the CASP checklist, and overall concerns regarding methodological limitations were rated as “minor concerns for all the review findings”. The most common issues were lack of consideration of the relationship between researcher and participants, no justification for data collection methods as it relates to data saturation and potential for recruitment bias. Concerns about relevance ranged from “minor” to “serious”. Minor concerns were due to studies restricting population to meningococcal disease with the potential to under-represent less severe forms of the disease. Serious concerns were due to the study population as well as a representation that Public Health England can be contacted by the public for advice which may not be obtainable in the UK. Concerns about coherence were “no or very minor” for all the review findings, as there was no data that contradicted the findings nor was there ambiguous data. Concerns about adequacy ranged from “no or very minor” to “serious”. There were serious concerns for review findings when evidence offered no rich data, moderate concerns for review findings when evidence offered some rich data and minor concerns for review findings that were based on evidence offering moderately rich data. The number of studies contributing to each subtheme ranged from 1 to 2.</p><p>No evidence was identified for the theme of timing of support.</p></div><div id="niceng195er11.s1.1.9.3"><h5>Benefits and harms</h5><p>All the evidence identified for this review focused on the views of parents or carers. However, the committee agreed that the recommendations made should apply equally to people with confirmed bacterial meningitis or meningococcal disease themselves. Although, they acknowledged that there may be differences in the types and delivery of support that is provided to people with confirmed bacterial meningitis or meningococcal disease and their parents or carers due to factors such as the developmental age of the individual. The committee noted that there were no differences in the emergent themes based on whether the suspected diagnosis was bacterial meningitis or meningococcal disease.</p><p>The protocol for this evidence review did not include neonates because the NICE guidance on <a href="https://www.nice.org.uk/guidance/ng195/chapter/Recommendations" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Neonatal infection</a> includes recommendations on support. However, the committee highlighted that the support needs covered in this review are very specific to bacterial meningitis and overlap significantly with recommendations about responding to potential long-term complications (which include neonates) and agreed that the recommendations about support post diagnosis that applied to babies (28 days to 1 year) should be extended to neonates.</p><p>The committee were aware of existing NICE guidance on <a href="https://www.nice.org.uk/Guidance/CG138" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">patient experience in adult NHS services</a> and <a href="https://www.nice.org.uk/guidance/ng204" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">babies, children and young people’s experience of healthcare</a>, and focused recommendations on support needs that were specific to bacterial meningitis and meningococcal disease.</p><p>There was moderate quality evidence from theme 1 (need for support) and theme 4 (type of support) that showed that parents would like to seek support and understanding about bacterial meningitis and meningococcal disease. Moderate quality evidence from sub-theme 1.1 (diagnosis) highlighted that parents would like access to emotional support at diagnosis, and they felt that it might be helpful to talk to someone who had insight into the situation (for example, parents having gone through a similar situation) and to have specific psychosocial support as it could be a very traumatic and upsetting time. The committee therefore recommended that emotional support and pastoral support should be provided for people with bacterial meningitis or meningococcal disease and their families and carers during hospitalisation. Based on the evidence, and their clinical knowledge and experience, the committee recommended that referral to psychological interventions should be considered for people with bacterial meningitis or meningococcal disease who need more specialist psychological support. The committee acknowledged that these were good practice points but were aware that these needs were often unmet.</p><p>The evidence (sub-theme 1.3: post-discharge from hospital) showed that parents also found the events following diagnosis of bacterial meningitis or meningococcal disease distressing and would like emotional support after their child was discharged from hospital. Based on this evidence, and their clinical knowledge and experience, the committee recommended that referral to psychosocial support should be considered as part of preparing for discharge.</p><p>The committee discussed that, based on their experience and on evidence reviewed in evidence reports I1 and I2, bacterial meningitis and meningococcal disease could increase the risk of poor educational outcomes. The committee reflected that this might be due to a wide range of other potential long-term complications, such as cognitive deficits, psychological and behavioural problems, and sensory impairment. In this review (sub-theme 2.2: educational), parents reported difficulties in accessing educational support for their child with cognitive impairment, visual impairment, and psychosocial impairments. Therefore, the committee recommended that the need for educational support should be considered as part of planning for discharge, and discussions should be had with the patient’s GP (and school, where appropriate) to facilitate post-discharge access to educational support where this is needed.</p><p>The committee discussed follow-up care after discharge and acknowledged that long-term monitoring is required to identify latent or evolving sequelae that may not be apparent at discharge (see evidence reviews I1 and I2). Sub-theme 2.1 (Navigating the system) showed that parents had difficulties in accessing sufficient or timely care for their child after discharge from hospital. Sub-theme 2.2 (educational) and 2.3 (developmental) also highlighted that parents felt that the risk of long-term complications, including developmental impairment, after bacterial meningitis were poorly understood and addressed by the health and social care system, making accessing services harder. The committee agreed that people with bacterial meningitis or meningococcal disease should have appropriate follow-up care with appropriate services so that they receive optimal care. This was also supported by evidence from sub-theme 4.1 (individualised to child) and 4.3 (reassurance), which showed that parents valued support that was tailored to their child’s needs and felt that appropriate follow-up care would provide them with reassurance in terms of their coping skills or their child’s recovery. Based on this evidence, the evidence on long-term complications (evidence reviews I1 and I2), and their clinical knowledge and experience, the committee recommended that follow-up reviews should be arranged; at 4-6 weeks after discharge for people with bacterial meningitis or meningococcal disease of any age; and at 1 year after discharge for neonates and babies. These reviews should cover the neurodevelopmental, orthopaedic (for meningococcal disease), sensory and psychosocial complications that were identified by evidence reviews I1 and I2 to be associated with bacterial meningitis and meningococcal disease.</p></div><div id="niceng195er11.s1.1.9.4"><h5>Cost effectiveness and resource use</h5><p>This qualitative review question did not consider decisions between competing alternatives and therefore is not directly relevant to the tools of economic evaluation. Nevertheless, the support recommendations made for confirmed bacterial meningitis and meningococcal disease do involve the use of scarce NHS resources and the committee made a qualitative assessment of the cost-effectiveness of their recommendations.</p><p>The committee considered that it would be cost-effective to arrange a review 4-6 weeks after discharge from hospital in order that any complications arising from bacterial meningitis or meningococcal disease could be identified to facilitate future management. The committee considered that these recommendations reflected good practice and would not represent a significant resource impact to the NHS. Likewise, they considered further review and follow-up would be cost-effective for babies (including newborn babies), children and young people as there are potential long-term complications that may not be apparent at an earlier stage.</p><p>The committee recognised that psychological interventions can be expensive but considered that referral would be cost-effective in the small population who would benefit from more specialist psychological support. The committee noted that current NHS practice was varied and hoped the recommendation would help standardise best practice.</p></div></div><div id="niceng195er11.s1.1.10"><h4>Recommendations supported by this evidence review</h4><p>This evidence review supports recommendations 1.1.14, 1.14.18 and 1.14.19. Other evidence supporting these recommendations can be found in evidence reviews on information for confirmed bacterial meningitis or meningococcal disease and long-term complications and follow-up for bacterial meningitis and meningococcal disease.</p></div></div><div id="niceng195er11.s1.rl.r1"><h3>References – included studies</h3><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="niceng195er11.s1.ref1"><p id="p-105">
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<strong>Clark 2013</strong>
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</p>Clark, L. J., Glennie, L., Audrey, S., Hickman, M., Trotter, C. L.
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The health, social and educational needs of children who have survived meningitis and septicaemia: the parents’ perspective. BMC public health,13, 954, 2013
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[<a href="/pmc/articles/PMC3852620/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3852620</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24112360" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24112360</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng195er11.s1.ref2"><p id="p-106">
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<strong>Haines 2005</strong>
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</p>Haines, C.
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Parents’ experiences of living through their child’s suffering from and surviving severe meningococcal disease. Nursing in critical care, 10, 78–89, 2005
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[<a href="https://pubmed.ncbi.nlm.nih.gov/15839239" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15839239</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng195er11.s1.ref3"><p id="p-107">
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<strong>Sweeney 2013</strong>
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</p>Sweeney, F., Viner, R. M., Booy, R., Christie, D.
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Parents’ experiences of support during and after their child’s diagnosis of meningococcal disease. Acta Paediatrica, 102, e126–30, 2013
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[<a href="https://pubmed.ncbi.nlm.nih.gov/23205710" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23205710</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng195er11.s1.ref4"><p id="p-108">
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<strong>Wisemantel 2018</strong>
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</p>Wisemantel, M., Maple, M., Massey, P. D., Osbourn, M., Kohlhagen, J.
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Psychosocial challenges of invasive meningococcal disease for children and their families. Australian Social Work, 71, 478–490, 2018</div></p></li><div id="niceng195er11.s1.rl.r1.1"><h4>Economic</h4><ul class="simple-list"><p>
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<b>No studies were identified which were applicable to this review question.</b>
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</p></ul></div></ul></div></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="niceng195er11.appa"><h3>Appendix A. Review protocols</h3><p id="niceng195er11.appa.et1"><a href="/books/NBK604232/bin/niceng195er11-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Review protocol for review question: What support is valued by patients with confirmed bacterial meningitis or meningococcal disease, and their families or carers?</a><span class="small"> (PDF, 208K)</span></p></div><div id="niceng195er11.appb"><h3>Appendix B. Literature search strategies</h3><p id="niceng195er11.appb.et1"><a href="/books/NBK604232/bin/niceng195er11-appb-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Literature search strategies for review question: What support is valued by patients with confirmed bacterial meningitis or meningococcal disease, and their families or carers?</a><span class="small"> (PDF, 232K)</span></p></div><div id="niceng195er11.appc"><h3>Appendix C. Qualitative evidence study selection</h3><p id="niceng195er11.appc.et1"><a href="/books/NBK604232/bin/niceng195er11-appc-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Study selection for: What support is valued by patients with confirmed bacterial meningitis or meningococcal disease, and their families or carers?</a><span class="small"> (PDF, 201K)</span></p></div><div id="niceng195er11.appd"><h3>Appendix D. Evidence tables</h3><p id="niceng195er11.appd.et1"><a href="/books/NBK604232/bin/niceng195er11-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Evidence tables for review question: What support is valued by patients with confirmed bacterial meningitis or meningococcal disease, and their families or carers?</a><span class="small"> (PDF, 231K)</span></p></div><div id="niceng195er11.appe"><h3>Appendix E. Forest plots</h3><div id="niceng195er11.appe.s1"><h4>Forest plots for review question: What support is valued by patients with confirmed bacterial meningitis or meningococcal disease, and their families or carers?</h4><p>No meta-analysis was conducted for this review question and so there are no forest plots.</p></div></div><div id="niceng195er11.appf"><h3>Appendix F. GRADE-CERQual tables</h3><p id="niceng195er11.appf.et1"><a href="/books/NBK604232/bin/niceng195er11-appf-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">GRADE tables for review question: What support is valued by patients with confirmed bacterial meningitis or meningococcal disease, and their families or carers?</a><span class="small"> (PDF, 212K)</span></p></div><div id="niceng195er11.appg"><h3>Appendix G. Economic evidence study selection</h3><p id="niceng195er11.appg.et1"><a href="/books/NBK604232/bin/niceng195er11-appg-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Study selection for: What support is valued by patients with confirmed bacterial meningitis or meningococcal disease, and their families or carers?</a><span class="small"> (PDF, 109K)</span></p></div><div id="niceng195er11.apph"><h3>Appendix H. Economic evidence tables</h3><div id="niceng195er11.apph.s1"><h4>Economic evidence tables for review question: What support is valued by patients with confirmed bacterial meningitis or meningococcal disease, and their families or carers?</h4><p>No evidence was identified which was applicable to this review question.</p></div></div><div id="niceng195er11.appi"><h3>Appendix I. Economic model</h3><div id="niceng195er11.appi.s1"><h4>Economic model for review question: What support is valued by patients with confirmed bacterial meningitis or meningococcal disease, and their families or carers?</h4><p>No economic analysis was conducted for this review question.</p></div></div><div id="niceng195er11.appj"><h3>Appendix J. Excluded studies</h3><div id="niceng195er11.appj.s1"><h4>Excluded studies for review question: What support is valued by patients with confirmed bacterial meningitis or meningococcal disease, and their families or carers?</h4></div><div id="niceng195er11.appj.s2"><h4>Excluded qualitative studies</h4><p>The excluded studies table only lists the studies that were considered and then excluded at the full-text stage for this review (N=9) and not studies (N=59) that were considered and then excluded from the search at the full-text stage as per the PRISMA diagram in <a href="#niceng195er11.appc">Appendix C</a> for the other review questions in the same search.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng195er11appjtab1"><a href="/books/NBK604232/table/niceng195er11.appj.tab1/?report=objectonly" target="object" title="Table 9" class="img_link icnblk_img" rid-ob="figobniceng195er11appjtab1"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng195er11.appj.tab1"><a href="/books/NBK604232/table/niceng195er11.appj.tab1/?report=objectonly" target="object" rid-ob="figobniceng195er11appjtab1">Table 9</a></h4><p class="float-caption no_bottom_margin">Excluded studies and reasons for their exclusion. </p></div></div></div><div id="niceng195er11.appj.s3"><h4>Excluded economic studies</h4><p>No economic evidence was identified for this review.</p></div></div><div id="niceng195er11.appk"><h3>Appendix K. Research recommendations – full details</h3><div id="niceng195er11.appk.s1"><h4>Research recommendations for review question: What support is valued by patients with confirmed bacterial meningitis or meningococcal disease, and their families or carers?</h4><p>No research recommendation was made for this review.</p></div></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><div class="title">Update information</div><p><b>March 2024:</b> This evidence review was originally produced for the NICE guideline on bacterial meningitis and meningococcal disease. This guideline made new recommendations for newborn babies with meningitis. We have moved these recommendations into the neonatal infection guideline, so that all the recommendations for newborn babies are in one place. See the NICE website for the <a href="http://www.nice.org.uk/guidance/ng195/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">guideline recommendations</a>.</p></div><div><p>Evidence review underpinning recommendations 1.1.14, 1.14.18 and 1.14.19 in the NICE guideline</p><p>This evidence review was developed by NICE</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2024.</div><div class="small"><span class="label">Bookshelf ID: NBK604232</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/38865499" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">38865499</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobniceng195er11tab1"><div id="niceng195er11.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">Summary of the protocol (PPC table)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK604232/table/niceng195er11.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng195er11.tab1_lrgtbl__"><table class="no_bottom_margin"><tbody><tr><th id="hd_b_niceng195er11.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_niceng195er11.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>People with confirmed bacterial meningitis or meningococcal disease.</div></li><li class="half_rhythm"><div>Parents or carers of babies, children, and young people with confirmed bacterial meningitis or meningococcal disease.</div></li><li class="half_rhythm"><div>Families or carers of adults with confirmed bacterial meningitis or meningococcal disease.</div></li></ul></td></tr><tr><th id="hd_b_niceng195er11.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Phenomenon of interest</th><td headers="hd_b_niceng195er11.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Views and experiences of the information provided when bacterial meningitis and/or meningococcal disease is confirmed.</p>
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<p>Themes will be identified from the literature. The committee identified the following potential themes (however, not all of these themes may be found in the literature, and additional themes may be identified):
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<ul><li class="half_rhythm"><div>Type of support</div></li><li class="half_rhythm"><div>Timing of support</div></li><li class="half_rhythm"><div>Availability of support</div></li></ul></p>
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</td></tr><tr><th id="hd_b_niceng195er11.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Context</th><td headers="hd_b_niceng195er11.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Studies sought will be those published in the English language from OECD high income European countries, Australia, Canada and New Zealand, from 2000 until the date the searches are run.</p>
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<p>The search cut-off date of 2000 was selected as microbiology has not changed much since 2000 and most relevant interventions were available by then. Including studies prior to this may not capture experiences reflective of current practice.</p>
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</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">OECD: Organisation for Economic Co-operation and Development</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng195er11tab2"><div id="niceng195er11.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of included studies</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK604232/table/niceng195er11.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng195er11.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng195er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_niceng195er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Population</th><th id="hd_h_niceng195er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Methods</th><th id="hd_h_niceng195er11.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Themes applied after thematic synthesis</th></tr></thead><tbody><tr><td headers="hd_h_niceng195er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng195er11.s1.ref1" rid="niceng195er11.s1.ref1">Clark 2013</a>
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</p>
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<p>Grounded theory</p>
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<p>UK & Ireland</p>
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</td><td headers="hd_h_niceng195er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N=194;</p>
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<p>n=18 invited for interview</p>
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<p>Parent/legal guardian of children who survived meningitis and/or septicaemia.</p>
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<p>Only, those parents reporting permanent after-effects, and who had accessed aftercare and support, were invited for interview.</p>
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<p>Age of children in years at the time of illness (mean): 3.83</p>
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</td><td headers="hd_h_niceng195er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Setting:</b> Purposive sampling from Meningitis Research Foundation members in the UK & Ireland</p>
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<p><b>Data collection and analysis:</b> Semi-structured interviews (face-to-face or over the phone), analysed using the constant comparison method from grounded theory</p>
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</td><td headers="hd_h_niceng195er11.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Access to support</div></li><li class="half_rhythm"><div>Type of support</div></li></ul></td></tr><tr><td headers="hd_h_niceng195er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng195er11.s1.ref2" rid="niceng195er11.s1.ref2">Haines 2005</a>
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</p>
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<p>Phenomenological</p>
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<p>England</p>
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</td><td headers="hd_h_niceng195er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N=7</p>
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<p>Parents of children admitted to PICU who survived severe meningococcal disease.</p>
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<p>Age: NR</p>
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</td><td headers="hd_h_niceng195er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Setting:</b> Purposive sampling from a PICU in England</p>
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<p><b>Data collection and analysis:</b> Semi-structured interviews (face-to-face), analysed using Colaizzi’s Interpretation Process</p>
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</td><td headers="hd_h_niceng195er11.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Need for support</div></li><li class="half_rhythm"><div>Source of support</div></li></ul></td></tr><tr><td headers="hd_h_niceng195er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng195er11.s1.ref3" rid="niceng195er11.s1.ref3">Sweeney 2013</a>
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</p>
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<p>General qualitative enquiry</p>
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<p>UK</p>
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</td><td headers="hd_h_niceng195er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N=244</p>
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<p>Parents/carers of survivors of serogroup B meningococcal Disease in childhood</p>
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<p>Age: NR</p>
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</td><td headers="hd_h_niceng195er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Setting:</b> Purposive sampling as part of a UK population-based study (MOSAIC)</p>
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<p><b>Data collection and analysis:</b> Structured interviews (over the phone), analysed using qualitative content analysis</p>
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</td><td headers="hd_h_niceng195er11.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Need for support</div></li><li class="half_rhythm"><div>Access to support</div></li><li class="half_rhythm"><div>Source of support</div></li><li class="half_rhythm"><div>Type of support</div></li></ul></td></tr><tr><td headers="hd_h_niceng195er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng195er11.s1.ref4" rid="niceng195er11.s1.ref4">Wisemantel 2018</a>
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</p>
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<p>General qualitative enquiry</p>
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<p>Australia</p>
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</td><td headers="hd_h_niceng195er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N=6</p>
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<p>Parents who had experienced a child or young person with an invasive meningococcal disease.</p>
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<p>Age: NR</p>
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</td><td headers="hd_h_niceng195er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Setting:</b> Convenience sampling from a regional area of New South Wales that includes a large city, regional centres, and rural and remote areas.</p>
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<p><b>Data collection and analysis:</b> Semi-structured interviews (face-to-face), analysed using thematic analysis with inductive and deductive techniques</p>
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</td><td headers="hd_h_niceng195er11.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Need for support</div></li><li class="half_rhythm"><div>Access to support</div></li><li class="half_rhythm"><div>Source of support</div></li></ul></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">MOSAIC: Meningococcal outcomes in adolescents and in children; NR: not reported; PICU: paediatric intensive care unit</p></div></dd></dl></dl></div></div></div></article><article data-type="fig" id="figobniceng195er11fig1"><div id="niceng195er11.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%201.%20Theme%20map.&p=BOOKS&id=604232_niceng195er11f1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK604232/bin/niceng195er11f1.jpg" alt="Figure 1. Theme map." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 1</span><span class="title">Theme map</span></h3><div class="caption"><p>BM: Bacterial Meningitis; MD: Meningococcal disease</p><p>+ = moderate quality evidence; - = low quality evidence; -- = very low quality evidence</p></div></div></article><article data-type="table-wrap" id="figobniceng195er11appjtab1"><div id="niceng195er11.appj.tab1" class="table"><h3><span class="label">Table 9</span><span class="title">Excluded studies and reasons for their exclusion</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK604232/table/niceng195er11.appj.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng195er11.appj.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng195er11.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng195er11.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Code [Reason]</th></tr></thead><tbody><tr><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Carter, B, Roland, D, Bray, L
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et al. (2020) A systematic review of the organizational, environmental, professional and child and family factors influencing the timing of admission to hospital for children with serious infectious illness. 15(7): e0236013 [<a href="/pmc/articles/PMC7377491/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7377491</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32702034" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32702034</span></a>]
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</td><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>- Study design not of interest for review</p>
|
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<p>A systematic review study; individual included studies have been assessed and none meet the inclusion criteria</p>
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</td></tr><tr><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Davie, S; Glennie, L; Rowland, K. (2012) Towards a meningitis free world-Can we eliminate meningococcal meningitis?. Contribution of the meningitis patient groups. Vaccine
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30(suppl2): B98–B105
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[<a href="https://pubmed.ncbi.nlm.nih.gov/22607905" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22607905</span></a>]
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</td><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>- Study design not of interest for review</p>
|
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<p>Overview of research and other activities by meningitis patient groups. No qualitative data presented</p>
|
|
</td></tr><tr><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Duramaz, B. B, Kihtir, H. S, Petmezci, M. T
|
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et al. (2020) Analysis of meningitis cases in pediatric intensive care unit: 8-year single center experience. Medical Journal of Bakirkoy
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16(1): 26–32
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</td><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>- Study design not of interest for review</p>
|
|
<p>Quantitative study. No qualitative data presented</p>
|
|
</td></tr><tr><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Shevlin, Mark, Coen, Pietro G; Borg, Jennie, Booy, Robert, Viner, Russell M; Christie, Deborah, Apajasalo, Arnau Aspesberro Baraff Beck Bellamy Borg Bowling Chin Christie de Winter Deyo Eiser Erickson Fellick Garratt Gill Guyatt Harrison Jenkinson Jenkinson Jones Joreskog Khan Krefetz Linstone Mobily Naess Nunnally Oranga Raphael Ridley Sander Starfield Steiger Viner Ware Ware (2016) Development of a health related quality of life measure for adolescents and young adults following invasive meningococcal disease. Applied Research in Quality of Life
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11(3): 971–982
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</td><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>- Insufficient presentation of results</p>
|
|
<p>Describes using focus groups of IMD survivors to develop questionnaire, but no presentation of qualitative data</p>
|
|
</td></tr><tr><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Strifler, L, Morris, S. K, Dang, V
|
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et al. (2014) The health burden of invasive meningococcal disease: A systematic review. Paediatrics and Child Health (Canada)
|
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19(6): e92 [<a href="https://pubmed.ncbi.nlm.nih.gov/26501470" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26501470</span></a>]
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</td><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>- Study design not of interest for review</p>
|
|
<p>Systematic review of quantitative studies</p>
|
|
</td></tr><tr><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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Taylor-Robinson, D, Elders, K, Milton, B
|
|
et al. (2010) Students’ attitudes to the communications employed during an outbreak of meningococcal disease in a UK school: A qualitative study. Journal of Public Health
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|
32(1): 32–37
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/19675024" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19675024</span></a>]
|
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</td><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not of interest for review</p>
|
|
<p>None of the respondents had suspected or confirmed meningitis or IMD</p>
|
|
</td></tr><tr><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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van Elsland, S. L, Springer, P, Steenhuis, I. H
|
|
et al. (2012) Tuberculous meningitis: barriers to adherence in home treatment of children and caretaker perceptions. Journal of Tropical Pediatrics
|
|
58(4): 275–9
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22141110" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22141110</span></a>]
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</td><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>- Not a high-income OECD country</p>
|
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<p>Study set in South Africa</p>
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</td></tr><tr><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Vermunt, L. C, Buysse, C. M, Joosten, K. F
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et al. (2011) Survivors of septic shock caused by Neisseria meningitidis in childhood: Psychosocial outcomes in young adulthood. Pediatric Critical Care Medicine
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12(6): e302–e309
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[<a href="https://pubmed.ncbi.nlm.nih.gov/21499180" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21499180</span></a>]
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</td><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>- Insufficient presentation of results</p>
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<p>No thematic analysis conducted. Responses to free-text questions and focus groups presented as quantitative outcomes</p>
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</td></tr><tr><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Williams, C. N, Eriksson, C, Piantino, J
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|
et al. (2018) Long-term Sequelae of Pediatric Neurocritical Care: The Parent Perspective. Journal of Pediatric Intensive Care
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|
7(4): 173–181
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[<a href="/pmc/articles/PMC6506677/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6506677</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31073491" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31073491</span></a>]
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</td><td headers="hd_h_niceng195er11.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>- Population not of interest for review</p>
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<p>Mixed population: Parents of children admitted to neurocritical care. Only 22% admitted for meningitis or encephalitis (67% admitted for TBI, 22% admitted for stroke. Results not presented or analysed separately for target population.</p>
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