Oulu University Hospital

FRIDAY, Feb. 27, 2026 -- Parental worry identifies most cases of severe illness in children and adolescents but has low specificity, according to a study published online Feb. 17 in JAMA Network Open . Hilla Pöyry, M.D., Ph.D., from Oulu University Hospital in Finland, and colleagues evaluated whether parents accurately identify severe illnesses in their children before emergency department evaluation using a symptom questionnaire. The analysis included data from 2,375 children and adolescents visiting a pediatric emergency department from May 2024 to May 2025. The researchers found that moderate-to-high parental worry showed the highest sensitivity (91.0 percent) but the lowest specificity (17.5 percent). There was modest diagnostic accuracy for other specific pediatric questions, but with limited additional value. The machine learning model (area under the receiver operating characteristic curve, 0.71) identified the strongest predictors of hospital admission as parental worry (feature importance score, 0.047), parent assessments of child or adolescent's general condition (feature importance score, 0.046), and need for treatment (feature importance score, 0.141). "While parental concern may serve as an initial screening indicator, it should be complemented by clinical evaluation and objective measures to avoid unnecessary escalation of care," the authors write. Abstract/Full Text

FRIDAY, Feb. 20, 2026 — Doctors would do well to heed any gut feelings parents might have about their child’s health, a new study says. Nine times out of 10, children were seriously ill if their parents had a clear or strong concern about their health, researchers reported Feb. 17 in JAMA Network Open . In fact, asking whether a parent is worried works better to identify seriously sick kids than comprehensive health questions focused on symptoms, researchers found. “Parental concern is an important warning sign,” said lead researcher Dr. Hilla Pöyry , a pediatric specialist at the University of Oulu in Finland. “If a parent is worried about the condition of their suddenly ill child, the child must have the opportunity to be assessed by a doctor,” Pöyry said in a news release. “A worried parent should not be left alone to make a remote assessment of their child’s condition.” For the study, researchers tracked nearly 2,400 children and teens treated at the Oulu University Hospital’s ER. Parents completed an extensive 36-item questionnaire as part of their child’s treatment. About 1 in 4 of the children had a severe illness requiring intensive care, surgery or a prolonged hospital stay, the study said. The point was to see if the digital questionnaire could be a good tool for parents to use to assess the health of a sick child at home before heading to the ER. However, the questionnaire was not accurate enough to replace an ER visit, especially if a parent was already concerned about their child’s health. “Our results show that such tools require careful validation, and they do not yet replace the assessment of a health care professional,” Pöyry said. Researchers found that items in the questionnaire related to parental worry were the best way to detect kids at greatest risk for serious illness. One question alone accurately identified 91% of kids who turned out to be very sick: “As a parent, how worried are you about your child's health at the moment?” “Although a parent may not always be able to describe the child’s symptoms in detail or accurately, they recognize a serious illness very well when asked a simple concern-based question,” Pöyry said. However, these “gut feeling” questions weren’t very good at ruling out cases where a child wasn’t sick, the study found. The best-performing question — “Do you feel your child is particularly ill or something is seriously wrong?” — identified healthy children only about 73% of the time. The parental worry question identified healthy kids just 18% of the time, despite how well it worked at detecting children who were actually sick. “While parental concern is an important red flag, it should be interpreted alongside clinical assessment to avoid unnecessary escalation of care,” the research team concluded in its paper. Sources University of Oulu, news release, Feb. 18, 2026 JAMA Network Open, Feb. 17, 2026

TUESDAY, Jan. 20, 2026 -- For treatment of unimalleolar Weber B ankle fractures with a congruent mortise on initial radiography but deemed unstable, cast immobilization is noninferior to surgery , according to a study published online Jan. 14 in The BMJ . Tero Kortekangas, M.D., Ph.D., from Oulu University Hospital in Finland, and colleagues conducted a randomized, noninferiority trial to compare cast immobilization to surgery using open reduction and internal plate fixation for unimalleolar Weber B ankle fractures with a congruent but unstable ankle mortise. A total of 840 skeletally mature patients age 16 years and older with an isolated Weber B fibula fracture were assessed for fracture instability. After exclusion of those with stable fracture, mortise incongruency, or fracture dislocation, 126 with a congruent but unstable ankle mortise were randomly assigned to receive conventional cast immobilization for six weeks or surgical treatment with open reduction and internal plate fixation followed by cast immobilization for six weeks (62 and 64 patients, respectively). In the primary intention-to-treat analysis of 121 participants with two-year follow-up, the researchers found that the mean Olerud-Molander Ankle Scores were 89 and 87 in the cast immobilization group and surgery group, respectively (mean difference, 1.3 points; 95 percent confidence interval, −4.8 to 7.3). There were no significant differences observed in any of the secondary outcomes (i.e., ankle function, pain, health-related quality of life, ankle range of motion, and radiographic outcome). Radiologic evidence of nonunion was seen for one participant in each group. "This lends further support to the evolving concept that the treatment of ankle fractures should focus on obtaining and maintaining a congruent ankle mortise until fracture union, using the most conservative means possible," the authors write. Abstract/Full Text Editorial