Search

Purpose of review Machine learning (ML), a branch of artificial intelligence, is influencing all fields in medicine, with an abundance of work describing its application to adult practice. ML in pediatrics is distinctly unique with clinical, technical, and ethical nuances limiting the direct translation of ML tools developed for adults to pediatric populations. To our knowledge, no work has yet focused on outlining the unique considerations that need to be taken into account when designing and implementing ML in pediatrics. Recent findings The nature of varying developmental stages and the prominence of family-centered care lead to vastly different data-generating processes in pediatrics. Data heterogeneity and a lack of high-quality pediatric databases further complicate ML research. In order to address some of these nuances, we provide a common pipeline for clinicians and computer scientists to use as a foundation for structuring ML projects, and a framework for the translation of a developed model into clinical practice in pediatrics. Throughout these pathways, we also highlight ethical and legal considerations that must be taken into account when working with pediatric populations and data. Summary Here, we describe a comprehensive outline of special considerations required of ML in pediatrics from project ideation to implementation. We hope this review can serve as a high-level guideline for ML scientists and clinicians alike to identify applications in the pediatric setting, generate effective ML solutions, and subsequently deliver them to patients, families, and providers.

Gait analysis consists of evaluating the individual through kinematic analysis, while walking along a surface. Kinematic analysis relates the relative movement between rigid bodies and finds applications in gait analysis. The purpose of this paper is to find the applications of gait analysis, the methodologies used to perform it and conclude about the different methodologies’ uses. A literature search was performed using PRISMA Guidelines. Twenty-two documents fulfilled the inclusion criteria. A total of 15 different countries presented researches in this topic. The areas within which these papers are published include Sports Medicine (7), Pediatric Medicine (1), General Medicine (11), Occupational Medicine (1), Engineering (2). Gait analysis has many different areas of intervention. Some gait parameters are interrelated and there are a few different methodologies available to perform gait analysis. A comprehensive table of results has been developed, where results are presented.

Transition from pediatric medicine to adult medicine for the endocrine patient is difficult for a variety of reasons. However, what remains important is that the patient gets the optimal care for their age and development and remains engaged in the healthcare system. Close follow-up is necessary as young adults transition to adult medicine, and screening for comorbidities is dependent on the specific disease process being addressed. Educating patients on the changes in roles as they become adults including important differences in privacy laws, healthcare coverage, and differences between adult and pediatric medicine is imperative to help young adults negotiate the difficult time of transition and hopefully avoid adverse outcomes of unsuccessful transition.

In recent years, our understanding about how to manage pediatric urology patients has improved substantially. This has resulted in this population receiving better long-term care, thus allowing these patients to live well into adulthood. This chapter explores how well the medical community has been adapting to this evolution in pediatric medicine, both in the broad context of complex pediatric care as well as within the realm of pediatric urology. Several existing initiatives for transitional pediatric and pediatric urologic care will be discussed, along with opportunities for collaboration to generate novel innovations specific to the pediatric urologic patient approaching transition into adulthood. Finally, the basic tenets of quality improvement work and its applicability to transitional care will be reviewed. Recommendations will be provided regarding how to develop, measure, refine, and spread quality improvement initiatives.

Complication avoidance and management with craniopharyngioma patients should focus more on avoidance; these complex lesions demand multidisciplinary evaluation and management long before knife is put to skin except if a patient presents in extremis. Although benign histologically, the invasiveness and location of these tumors makes their management difficult over the long term. Expertise in endocrinology, neurosurgery, radiation oncology, ophthalmology, reproductive medicine, and, frequently, pediatric medicine are required to deliver the best possible care. In our practice, these patients are managed by a multidisciplinary team that is intimately involved in all phases of care.

I want to pick up where I left off in Chap. 3. In some respects, it is peculiar that, in the face of the resounding backlash against ‘Big Ethics,’ as it was often called in the 1970s, some physicians continued to entertain the notion that philosophers should, and some of them argued must, become “involved” in clinical medicine. Around the same time (early 1980s) as Alan Fleischman was putting his program for residents in place, for instance, the pediatrician Tomas Silber stated his belief that without such actual, regular involvement in clinical affairs, what he termed the “data base” for understanding, much less contending productively with, the moral issues he regarded as inherent to the daily practice of at least pediatric medicine, would be plainly missing. Precisely that “base” is necessary, he argued, for the medical tasks at hand in any clinical situation. Thus, quite understandably, Silber lamented the “absence of these professionals”—that is, philosophers—“from our daily lives,” although, with Siegler, he endorsed the idea that physicians must for their part immerse themselves in philosophy and theology (Silber TJ, Pediatric Ann 10:13–14, 1981).