{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:35:39Z","timestamp":1792798539946,"version":"4.5.0"},"reference-count":28,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T00:00:00Z","timestamp":1595462400000},"content-version":"unspecified","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Sydney Children\u2019s Hospital Network","id":[{"id":"https:\/\/ror.org\/02tj04e91","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004463","name":"Bupa Health Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004463","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Australian National Health and Medical Research Council","award":["Partnership grant APP1065898"],"award-info":[{"award-number":["Partnership grant APP1065898"]}],"id":[{"id":"https:\/\/ror.org\/011kf5r70","id-type":"ROR","asserted-by":"crossref"}]},{"name":"New South Wales Kids and Families"},{"name":"South Australian Department of Health"},{"name":"Children\u2019s Health Queensland","id":[{"id":"https:\/\/ror.org\/02t3p7e85","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>To estimate adherence to clinical practice guidelines in selected settings at a population level for Australian children with type 1 diabetes mellitus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research design and methods<\/jats:title>\n                    <jats:p>Medical records of children with type 1 diabetes mellitus aged 0\u201315 years in 2012\u20132013 were targeted for sampling across inpatient, emergency department and community visits with specialist pediatricians in regional and metropolitan areas and tertiary pediatric hospitals in three states where approximately 60% of Australian children reside. Clinical recommendations extracted from two clinical practice guidelines were used to audit adherence. Results were aggregated across types of care (diagnosis, routine care, emergency care).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Surveyors conducted 6346 indicator assessments from an audit of 539 healthcare visits by 251 children. Average adherence across all indicators was estimated at 79.9% (95% CI 69.5 to 88.0). Children with type 1 diabetes mellitus have higher rates of behavioral and psychological disorders, but only a third of children (37.9%; 95%\u2009CI 11.7 to 70.7) with suboptimal glycemic control (eg, hemoglobin A1c &gt;10% or 86\u2009mmol\/mol) were screened for psychological disorders using a validated tool; this was the only indicator with &lt;50% estimated adherence. Adherence by care type was: 86.1% for diagnosis (95%\u2009CI 76.7 to 92.7); 78.8% for routine care (95%\u2009CI 65.4 to 88.9) and 83.9% for emergency care (95%\u2009CI 78.4 to 88.5).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most indicators for care of children with type 1 diabetes mellitus were adhered to. However, there remains room to improve adherence to guidelines for optimization of practice consistency and minimization of future disease burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjdrc-2019-001141","type":"journal-article","created":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T07:05:36Z","timestamp":1595574336000},"page":"e001141","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Assessing guideline adherence in the management of type 1 diabetes mellitus in Australian children: a population-based sample survey"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3125-8253","authenticated-orcid":false,"given":"Richard G","family":"McGee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris T","family":"Cowell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaston","family":"Arnolda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsuen P","family":"Ting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Hibbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S Bruce","family":"Dowton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Braithwaite","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,7,23]]},"reference":[{"key":"2020072404031306000_8.1.e001141.1"},{"key":"2020072404031306000_8.1.e001141.2","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1007\/s00125-016-3948-x","article-title":"Burden of diabetes in Australia: life expectancy and disability-free life expectancy in adults with diabetes","volume":"59","author":"Huo","year":"2016","journal-title":"Diabetologia"},{"key":"2020072404031306000_8.1.e001141.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.16425"},{"key":"2020072404031306000_8.1.e001141.4","doi-asserted-by":"publisher","DOI":"10.1177\/1932296816648983"},{"key":"2020072404031306000_8.1.e001141.5","unstructured":"Australian Institute of Health and Welfare . 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