{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T12:45:13Z","timestamp":1779281113216,"version":"3.51.4"},"reference-count":67,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec><jats:title>Context<\/jats:title><jats:p>Follow-up strategies after emergency department (ED) discharge, alias safety netting, is often based on the gut feeling of the attending physician.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To systematically identify evaluated safety-netting strategies after ED discharge and to describe determinants of paediatric ED revisits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data sources<\/jats:title><jats:p>MEDLINE, Embase, CINAHL, Cochrane central, OvidSP, Web of Science, Google Scholar, PubMed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study selection<\/jats:title><jats:p>Studies of any design reporting on safety netting\/follow-up after ED discharge and\/or determinants of ED revisits for the total paediatric population or specifically for children with fever, dyspnoea and\/or gastroenteritis. Outcomes included complicated course of disease after initial ED visit (eg, revisits, hospitalisation).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data extraction<\/jats:title><jats:p>Two reviewers independently assessed studies for eligibility and study quality. As meta-analysis was not possible due to heterogeneity of studies, we performed a narrative synthesis of study results. A best-evidence synthesis was used to identify the level of evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We summarised 58 studies, 36% (21\/58) were assessed as having low risk of bias. Limited evidence was observed for different strategies of safety netting, with educational interventions being mostly studied. Young children, a relevant medical history, infectious\/respiratory symptoms or seizures and progression\/persistence of symptoms were strongly associated with ED revisits. Gender, emergency crowding, physicians\u2019 characteristics and diagnostic tests and\/or therapeutic interventions at the index visit were not associated with revisits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Within the heterogeneous available evidence, we identified a set of strong determinants of revisits that identify high-risk groups in need for safety netting in paediatric emergency care being related to age and clinical symptoms. Gaps remain on intervention studies concerning specific application of a uniform safety-netting strategy and its included time frame.<\/jats:p><\/jats:sec>","DOI":"10.1136\/archdischild-2014-306953","type":"journal-article","created":{"date-parts":[[2015,7,11]],"date-time":"2015-07-11T02:45:41Z","timestamp":1436582741000},"page":"131-139","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":36,"title":["Tools for \u2018safety netting\u2019 in common paediatric illnesses: a systematic review in emergency care"],"prefix":"10.1136","volume":"101","author":[{"given":"Evelien","family":"de Vos-Kerkhof","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorien 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