Journal of Pediatric Surgical Nursing

Introduction: Many children undergo invasive and noninvasive procedures in the pediatric medical setting, which can be associated with pain and anxiety. Both pharmacological and nonpharmacological interventions are currently being used to minimize pain and anxiety in pediatric patients in the medical setting. Music therapy is an evidence-based, cost-effective, and nonpharmacological service administered by a board-certified music therapist which may reduce pediatric pain and anxiety during procedures. We will undertake a systematic review and meta-analysis that will comprehensively analyze the quantitative publications that detail the effects of music therapy on pediatric pain and anxiety for patients undergoing invasive or noninvasive medical procedures. Method: This protocol is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement and is registered in the International Prospective Register of Systematic Reviews (Prospero; CRD42023474635). A three-step, iterative search strategy will include (1) an initial scoping search, (2) development and execution of a comprehensive search strategy, and (3) a search for additional publications. Procedures for disagreements among reviewers and the article screening process are outlined. Statistical analyses including analysis of outcomes and sensitivity analysis has been determined. A plan for critical appraisal of sources using the Grading Recommendations Assessment, Development, and Evaluation (GRADE) and quality of evidence using the Outcome Reporting Bias in Trials (ORBIT) of evidence is also present in this protocol. Conclusion: This protocol is presented with the intention to execute and publish results of this systematic review and meta-analysis to help inform clinical practice and future research.

Background: Artificial intelligence (AI) language models have emerged as tools capable of generating human-like text-to-user prompts on a wide range of topics. However, it is known that the performance and content quality of these language models have not been evaluated in certain medical fields. The aim of our study is to evaluate the performance of AI language models ChatGPT and Bard in providing parent information about hypospadias and compare the quality of the information with reference to a source. Methods: In this study, 38 frequently asked questions about hypospadias that were publicly posted on social media and websites by reputable institutions and societies were evaluated. The quality of responses was evaluated using the global quality score (GQS) with reference to the European Association of Urology guidelines. The number of words and sentences of the responses were recorded by the researchers. Results: In this study, it was found that the response quality of Bard was higher than ChatGPT in the question group related to the preoperative preparation category (p = .042). The quality of ChatGPT and Bard's responses to the other questions, except for the questions in the preoperative preparation category, was similar and above average. It was found that the number of words (p < .001) and sentences (p < .001) of Bard's responses to the questions were higher than ChatGPT. Discussion: Large language models (LLMs) had limitations in providing parents with quality information about hypospadias. Parents should therefore be careful when using LLMs as a source of information.

Osteochondritis dissecans (OCD) is a focal, idiopathic alteration of subchondral bone with the potential for instability and disruption of adjacent articular cartilage causing pain or discomfort in the knee and, if left untreated, may cause increasing disability and progressive arthritic change of the joint. This article presents a case study of a 16-year-old female who presented with intermittent right lateral knee pain for several years with no acute traumatic injury. Diagnostic imaging demonstrated subchondral changes of the lateral femoral condyle consistent with osteochondritis dissecans. The patient was diagnosed with an unstable OCD of the right knee and underwent surgical treatment. Following treatment, the patient attended formal physical therapy two times per week and began a gradual return to sport protocol at 4 months post-operatively. This case study will demonstrate the complexities surrounding the clinical presentation, diagnostic workup, and treatment options for this challenging diagnosis. The importance of accurate imaging and aggressive treatment of unstable OCD lesions will be highlighted.