The differential diagnosis of hypernatraemia in children, with ...

The Diagnosis of Salt Poisoning Leading to Hypematraemia in Children – September 2009
2. Methodology
This section sets out in detail the methods used to develop the evidence for the guideline.
The methods are in accordance with the RCPCH Quality of Practice Committee standards
for guideline development 9 .
Guideline Development Group (GDG)
A multidisciplinary guideline development group (GDG) was established. The group
included health professionals in paediatrics, sodium handling and evidence-based medicine.
Support was provided from the Royal College of Paediatrics and Child Health. Details of
all the members are listed at the beginning of the document.
Development of the scope
The guideline development group agreed a scope for the guideline explicitly stating the
need for the guideline, the population and topic/clinical areas to be included and not
included in the final document.
Identifying the evidence
The aim of the literature review was to seek to identify all available published evidence
relevant to the questions identified by the project group in relation to hypernatraemia in
children. Where evidence was not available, this is stated and the need for future research
specified. Where evidence in children is lacking but exists from studies in adults this was
sought and incorporated into the guidance.
Literature searches were developed by an information specialist focusing on the two
clinical questions: ‘What are the possible causes of Hypernatraemia in children and
their frequency in children?’ and ‘What key tests will help distinguish excess sodium
intake from water depletion?’. Search strategies were initially developed on the Medline
database and subsequently adapted for other databases. The search was run using the
Ovid interface on the following databases; Medline (January 1966 to September 2005),
PreMedline (March 2006), OldMedline (1950 to 1965), Embase (January 1980 to
September 2005) and CINAHL (January 1982 to March 2006). No language restrictions
were applied to the search. Modified filters were developed to exclude letters (unless they
presented primary data), commentaries, editorials and newspaper articles. Additionally
a filter was used on the searches to exclude animal studies. No systematic attempt was
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