Hilary Whyte | University of Toronto (original) (raw)
Papers by Hilary Whyte
Journal of Perinatology, 2019
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Pediatric Research, May 19, 2023
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Frontiers in Pediatrics, Dec 11, 2019
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Telemedicine Journal and E-health, Oct 1, 2022
Background/Aims: Clinical trials evaluating facility-to-facility telemedicine may include sites t... more Background/Aims: Clinical trials evaluating facility-to-facility telemedicine may include sites that have limited research experience. For the trial to be successful, these sites must correctly perform research-related tasks. This study aimed to determine whether health care professionals at community hospitals could accurately identify simulated study eligible patients and submit data to a research coordinating center. Methods: Twenty-seven community hospitals in the United States and Canada participated in this study. An electronic survey was sent to one designated health care professional at each site. The survey included a description of trial eligibility criteria and five written neonatal resuscitation scenarios. For each scenario, the participant determined whether the neonate was study eligible. One scenario required participants to submit 14 data elements to the coordinating center. Accuracy of study eligibility and data submission was summarized using standard descriptive statistics. Results: The survey response rate was 100% (27/27). Overall accuracy in determining study eligibility was 89% (120/135), and accuracy varied across the five scenarios (range 82-93%). Overall accuracy of data submission was 92% (310/336). Data were >95% accurate for 9 of the 14 data elements, with 100% accuracy achieved for 6 data elements. These results were used to clarify eligibility criteria, inform database design, and improve training materials for the subsequent clinical trial. Conclusions: Health care professionals at community hospitals accurately determined trial eligibility and submitted study data based on written clinical scenarios. Research teams conducting telemedicine trials with community hospitals should consider completing pre-trial simulation activities to identify opportunities for improving trial processes and materials.
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Journal of Perinatology, Feb 12, 2020
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Paediatrics and Child Health, Jun 1, 2012
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Pediatric Research, Sep 1, 1996
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Pediatric Research, Oct 1, 1986
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Early Human Development, Jul 1, 2020
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Pediatric Radiology, Sep 21, 2011
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Paediatrics and Child Health, May 1, 2010
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Obstetrical & Gynecological Survey, Apr 1, 2001
To describe mortality and neurodevelopmental outcome before and after the introduction of rescue ... more To describe mortality and neurodevelopmental outcome before and after the introduction of rescue therapy with natural surfactant in two neonatal units in Toronto, Canada, a retrospective cohort study of 891 liveborn 23-26 wk gestational age infants, 421 presurfactant (1982-1987) and 470 postsurfactant (1990-1994) was performed. Overall mortality was stable over time (41% vs 35%, p = 0.077), but declined for inborn 24 (71% vs 43%, p = 0.03) and 26 wk (26% vs 13%, p = 0.01) gestational age infants and was higher in surfactant-treated infants (p < 0.0001). Chronic lung disease (61% vs 34%, p < 0.0001) and bilateral blindness (8% vs 4%, p = 0.004) declined over time, with stable rates of cerebral palsy (12% vs 15%), cognitive deficit (27% vs 26%) and aided sensorineural hearing loss (5% vs 4%). Sixty-five percent of surviving infants in both eras were free from neurodevelopmental impairment, and severe impairment declined over time (p = 0.035). This study shows no secular change in overall mortality in a large cohort of 23-26 wk gestational age infants since the introduction of rescue therapy with natural surfactant. However, it does suggest that maternal transfer to and delivery of all extremely preterm infants in high risk perinatal centres is justified.
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Neoreviews, Apr 1, 2005
A 2,216-g baby boy is born at 37 weeks’ gestation to a 34-year-old gravida 2, para 1 female. The ... more A 2,216-g baby boy is born at 37 weeks’ gestation to a 34-year-old gravida 2, para 1 female. The pregnancy was uncomplicated until the day prior to delivery, when a biophysical profile score of 4/8 was obtained on assessment. Fetal heart rate decelerations to 80 beats/min and multiple late decelerations were noted the evening of delivery, and an emergent cesarean section is planned. The male infant is delivered precipitously prior to entering the operating room. Placental abruption is evident after delivery. At birth, the baby is limp but has spontaneous respirations, with a respiratory rate of 60 breaths/min. Mild intercostal retractions are evident. Femoral pulses are weak, but the heart rate is detected at 130 beats/min. On auscultation, heart sounds are not audible. Apgar scores are 7, 7, and 8 at 1, 5, and 10 minutes, respectively. Shortly after initial assessment, continuous positive airway pressure (CPAP) is applied at 4 to 5 cm H2O, and the baby is transported to the neonatal intensive care unit where the blood pressure is 44/16 mm Hg (mean, 27 mm Hg) and the oxygen saturation is 98% (with CPAP). Color and tone are poor, and the baby subsequently receives bag-and-mask ventilation and a bolus of 10 mL/kg normal saline via a peripheral intravenous …
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American Journal of Perinatology, Jul 1, 1988
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Paediatrics and Child Health, 2010
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Paediatrics & Child Health, 2015
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Paediatrics and Child Health, May 1, 2010
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The Journal of Pediatrics, Feb 1, 2020
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Frontiers in Human Neuroscience, Jul 14, 2020
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Journal of Perinatology, 2019
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Pediatric Research, May 19, 2023
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Frontiers in Pediatrics, Dec 11, 2019
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Telemedicine Journal and E-health, Oct 1, 2022
Background/Aims: Clinical trials evaluating facility-to-facility telemedicine may include sites t... more Background/Aims: Clinical trials evaluating facility-to-facility telemedicine may include sites that have limited research experience. For the trial to be successful, these sites must correctly perform research-related tasks. This study aimed to determine whether health care professionals at community hospitals could accurately identify simulated study eligible patients and submit data to a research coordinating center. Methods: Twenty-seven community hospitals in the United States and Canada participated in this study. An electronic survey was sent to one designated health care professional at each site. The survey included a description of trial eligibility criteria and five written neonatal resuscitation scenarios. For each scenario, the participant determined whether the neonate was study eligible. One scenario required participants to submit 14 data elements to the coordinating center. Accuracy of study eligibility and data submission was summarized using standard descriptive statistics. Results: The survey response rate was 100% (27/27). Overall accuracy in determining study eligibility was 89% (120/135), and accuracy varied across the five scenarios (range 82-93%). Overall accuracy of data submission was 92% (310/336). Data were >95% accurate for 9 of the 14 data elements, with 100% accuracy achieved for 6 data elements. These results were used to clarify eligibility criteria, inform database design, and improve training materials for the subsequent clinical trial. Conclusions: Health care professionals at community hospitals accurately determined trial eligibility and submitted study data based on written clinical scenarios. Research teams conducting telemedicine trials with community hospitals should consider completing pre-trial simulation activities to identify opportunities for improving trial processes and materials.
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Journal of Perinatology, Feb 12, 2020
Bookmarks Related papers MentionsView impact
Paediatrics and Child Health, Jun 1, 2012
Bookmarks Related papers MentionsView impact
Pediatric Research, Sep 1, 1996
Bookmarks Related papers MentionsView impact
Pediatric Research, Oct 1, 1986
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Early Human Development, Jul 1, 2020
Bookmarks Related papers MentionsView impact
Pediatric Radiology, Sep 21, 2011
Bookmarks Related papers MentionsView impact
Paediatrics and Child Health, May 1, 2010
Bookmarks Related papers MentionsView impact
Obstetrical & Gynecological Survey, Apr 1, 2001
To describe mortality and neurodevelopmental outcome before and after the introduction of rescue ... more To describe mortality and neurodevelopmental outcome before and after the introduction of rescue therapy with natural surfactant in two neonatal units in Toronto, Canada, a retrospective cohort study of 891 liveborn 23-26 wk gestational age infants, 421 presurfactant (1982-1987) and 470 postsurfactant (1990-1994) was performed. Overall mortality was stable over time (41% vs 35%, p = 0.077), but declined for inborn 24 (71% vs 43%, p = 0.03) and 26 wk (26% vs 13%, p = 0.01) gestational age infants and was higher in surfactant-treated infants (p < 0.0001). Chronic lung disease (61% vs 34%, p < 0.0001) and bilateral blindness (8% vs 4%, p = 0.004) declined over time, with stable rates of cerebral palsy (12% vs 15%), cognitive deficit (27% vs 26%) and aided sensorineural hearing loss (5% vs 4%). Sixty-five percent of surviving infants in both eras were free from neurodevelopmental impairment, and severe impairment declined over time (p = 0.035). This study shows no secular change in overall mortality in a large cohort of 23-26 wk gestational age infants since the introduction of rescue therapy with natural surfactant. However, it does suggest that maternal transfer to and delivery of all extremely preterm infants in high risk perinatal centres is justified.
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
Neoreviews, Apr 1, 2005
A 2,216-g baby boy is born at 37 weeks’ gestation to a 34-year-old gravida 2, para 1 female. The ... more A 2,216-g baby boy is born at 37 weeks’ gestation to a 34-year-old gravida 2, para 1 female. The pregnancy was uncomplicated until the day prior to delivery, when a biophysical profile score of 4/8 was obtained on assessment. Fetal heart rate decelerations to 80 beats/min and multiple late decelerations were noted the evening of delivery, and an emergent cesarean section is planned. The male infant is delivered precipitously prior to entering the operating room. Placental abruption is evident after delivery. At birth, the baby is limp but has spontaneous respirations, with a respiratory rate of 60 breaths/min. Mild intercostal retractions are evident. Femoral pulses are weak, but the heart rate is detected at 130 beats/min. On auscultation, heart sounds are not audible. Apgar scores are 7, 7, and 8 at 1, 5, and 10 minutes, respectively. Shortly after initial assessment, continuous positive airway pressure (CPAP) is applied at 4 to 5 cm H2O, and the baby is transported to the neonatal intensive care unit where the blood pressure is 44/16 mm Hg (mean, 27 mm Hg) and the oxygen saturation is 98% (with CPAP). Color and tone are poor, and the baby subsequently receives bag-and-mask ventilation and a bolus of 10 mL/kg normal saline via a peripheral intravenous …
Bookmarks Related papers MentionsView impact
American Journal of Perinatology, Jul 1, 1988
Bookmarks Related papers MentionsView impact
Paediatrics and Child Health, 2010
Bookmarks Related papers MentionsView impact
Paediatrics & Child Health, 2015
Bookmarks Related papers MentionsView impact
Paediatrics and Child Health, May 1, 2010
Bookmarks Related papers MentionsView impact
The Journal of Pediatrics, Feb 1, 2020
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Frontiers in Human Neuroscience, Jul 14, 2020
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