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We read with interest the recent paper by Doull et al1 which explores the optimal model for delivery of paediatric cystic fibrosis (CF) care. The authors compared three models of paediatric CF care within their established CF network: full centre care; local clinic based care with annual review by the CF centre; and hybrid care, where a child is usually reviewed at least three times a year by the specialist centre. Three outcomes were considered: nutritional status, pulmonary function and prevalence of chronic Pseudomonas aeruginosa infection. The only significant finding was that the mean forced expiratory volume in one second (FEV1) was lower among children receiving local clinic based care than full centre care (74.5% predicted vs 89.2%; p=0.001), and the authors extrapolate from this that the model of care may affect long-term clinical outcomes for children with CF.
The data presented are interesting and highly relevant to all involved in CF care in South and Mid Wales. However, the study has several shortcomings which limit generalisation of its findings to other paediatric CF populations. It is crucial that these are highlighted to the varied audience of the …