Current practices in pediatric hospital-acquired thromboembolism: Survey of the Children's Hospital Acquired Thrombosis (CHAT) Consortium.

Background: A rise in hospital-acquired venous thromboembolism (HA-VTE) in children has led to increased awareness regarding VTE prophylaxis and risk assessment. Despite no consensus exists regarding these practices in pediatrics. Objective: To describe common practices in VTE prophylaxis, VTE risk assessment models, and anticoagulation dosing strategies in pediatric hospitals that are members of the Children's Hospital Acquired Thrombosis (CHAT) Consortium. Methods: An electronic survey of 44 questions evaluating practices surrounding pediatric HA-VTE risk assessment and prevention was distributed between August 9, 2021, and August 30, 2021, to the primary investigators from the 32 institutions within the CHAT Consortium. Results: The survey response rate was 100% (n = 32). In total, 85% (n = 27) of the institutions assess HA-VTE, but only 63% (n = 20) have formal hospital guidelines. Within the institutions with formal guidelines, 100% (n = 20) include acute systemic inflammation or infection and presence of a central venous catheter (CVC) as risk factors for VTE. Pharmacologic prophylaxis is prescribed at 87% (28) of institutions, with enoxaparin being the most frequent (96%, n = 27). Variability in responses persisted regarding risk factors, risk assessment, thromboprophylaxis, dosing of prophylactic anticoagulation or anticoagulant drug monitoring. A majority of providers were comfortable providing thromboprophylaxis across all age groups. In addition, the global coronavirus disease 2019 increased the providers' use of prophylactic anticoagulation 78% (n = 25). Conclusion: Practices among institutions are variable in regard to use of HA-VTE prophylaxis, risk assessment, or guideline implementation, highlighting the need for further research and a validated risk assessment model through groups like the CHAT Consortium.

Computer- vs. paper-based tasks: are they equivalent?

In 1992, Dillon published his critical review of the empirical literature on reading from paper vs. screen. However, the debate concerning the equivalence of computer- and paper-based tasks continues, especially with the growing interest in online assessment. The current paper reviews the literature over the last 15 years and contrasts the results of these more recent studies with Dillon's findings. It is concluded that total equivalence is not possible to achieve, although developments in computer technology, more sophisticated comparative measures and more positive user attitudes have resulted in a continuing move towards achieving this goal. Many paper-based tasks used for assessment or evaluation have been transferred directly onto computers with little regard for any implications. This paper considers equivalence issues between the media by reviewing performance measures. While equivalence seems impossible, the importance of any differences appears specific to the task and required outcomes.

Comment on evaluating cognitive demand.

In 2005 Shieh and Chen found differences in EEG responses when using computer- and paper-based display media, which they attributed to different cognitive demands. This paper supports this interpretation by reporting an unpublished study in which cognitive demand was measured using a self-report workload measure.