{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:46:34Z","timestamp":1791985594777,"version":"4.4.0"},"reference-count":42,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005744","name":"Lastentautien Tutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005744","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neurological patients represent a small yet resource\u2010demanding group in pediatric emergency departments (PEDs). Their pathways and resource needs remain poorly understood. This population\u2010based real\u2010world data study aims to bridge this gap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed neurological visits from 2021 to 2023 at the sole PED serving 300,000 children using process mining and statistical analysis. Neurological visits included patients triaged for neurologist evaluation and those with neurological complaints and\/or diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 4854 neurological visits, constituting 5% of PED visits. Seizure and headache comprised 64% of the chief complaints; seizures dominated the highest acuity visits, while headache was linked to visits with lower acuity. Neurological patients had a nearly fivefold increased risk of requiring immediate lifesaving interventions compared to non\u2010neurological patients. Half of the highest acuity patients were 1\u20135\u2009years old. Patient disposition was most strongly associated with acuity: 81% of highest acuity patients were admitted and 15% of them to the pediatric intensive care or surgical unit, whereas only 18% of stable patients were hospitalized. Variability of patient pathways was moderate. 87% of patients adhered to one of four most common pathways where disposition decision was made without advanced testing. Over 30 pathways were identified for patients needing advanced tests. These patients presented with higher acuity, non\u2010seizure complaints and increased admissions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This population\u2010based study pioneers process mining for analyzing patient care processes and resource utilization of neurological patients at the PED. It highlights the critical nature of pediatric neurological emergencies and uncovers the variability of patient needs and pathways.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70743","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T13:11:51Z","timestamp":1788959511000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pathways of Patients With Neurological Emergencies at Pediatric Emergency Department: A Process\u2010Based Data Mining Study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1362-8053","authenticated-orcid":false,"given":"Henna","family":"Aro","sequence":"first","affiliation":[{"name":"Department of Paediatric Neurology HUS Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuomo","family":"Antikainen","sequence":"additional","affiliation":[{"name":"Department of Mathematics and System Analysis Aalto University  Espoo Finland"},{"name":"New Children's Hospital Clinical Trials Unit HUS Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Videman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5031-4495","authenticated-orcid":false,"given":"Elina","family":"W\u00e4rnhjelm","sequence":"additional","affiliation":[{"name":"Department of Paediatrics HUS Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3574-6510","authenticated-orcid":false,"given":"Erika","family":"Ignatius","sequence":"additional","affiliation":[{"name":"Department of Paediatric Neurology HUS Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0156-1614","authenticated-orcid":false,"given":"Pirjo","family":"Isohanni","sequence":"additional","affiliation":[{"name":"Department of Paediatric Neurology HUS Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7267-5811","authenticated-orcid":false,"given":"Miika","family":"Koskinen","sequence":"additional","affiliation":[{"name":"Diagnostic Center and New Children's Hospital HUS Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.181426"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12020279"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.pec.0000236830.39194.c0"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpn.2021.03.017"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcped.2020.09.005"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.25122\/jml\u20102023\u20100476"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100041\u20101730936"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-85729-491-3"},{"issue":"1","key":"e_1_2_12_10_1","first-page":"S35","article-title":"The Neuropediatrician and the Pediatric Neurological Emergencies","volume":"47","author":"Garc\u00eda\u2010Pe\u00f1as J. 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