Ashma Krishan

'Developing an evidence-based response to proposed new guidelines for scanning children with Urinary Tract Infections' - Urinary tract infection (UTI) is a common bacterial disease of childhood. With it comes a low but non-negligible risk of long-term complications. The National Institute for Health and Clinical Excellence (NICE) has recently published new guidance for the clinical management of children with UTI, in particular regarding when to use a scanning technique that requires ionising radiation. The key issue at heart is the desire to limit the number of unnecessary investigations in children with UTI, balanced with the importance of detecting abnormalities that may prove to be clinically significant in the long term. The NICE guidance has provoked considerable debate among paediatricians and the purpose of this bursary project was to contribute to the debate by producing an evidence-based response to the NICE recommendations.

Ashma Krishan, a student at the University of Glasgow, undertook this project, named alongside her Statistics supervisor Professor John McColl, using information from a database of almost 3,000 patients that had been gathered at the Renal Unit, Royal Hospital for Sick Children, Glasgow (Dr. Jim Beattie, Dr. Deepa Athavale). Ashma discovered that ultrasound scanning cannot wholly be relied upon to detect structural damage due to UTI, and that clinical symptoms as well as a past history of UTI are predictive of scanning abnormalities. This suggests that the published NICE guidelines may not, therefore, be wholly appropriate for best patient care.

Speaking of her experience, Ashma said:

"Initially I was given data which did not really mean very much to me. However, after working on it for a few weeks and being able to draw conclusions, I felt delighted with myself, and I have now decided to do a MSc next year continuing in the field of medical statistics."