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When to invest in clinical guidelines for children? A practice oriented tool to facilitate decision-making
Inge Schalkers1, Clair Enthoven1, Joske Bunders1
1Athena Institute, VU University Amsterdam, The Netherlands.
Insights
A new flowchart helps guideline developers ensure clinical guidelines address children's unique health needs. This tool promotes structural consideration of pediatric populations in guideline development, aiming for more child-centered healthcare.
Area of Science:
- Health Services Research
- Clinical Guideline Development
- Pediatric Healthcare
Background:
- Children's unique developmental needs are often overlooked in clinical guideline development.
- Existing guidelines may not adequately address pediatric-specific health concerns.
- There is a need for systematic approaches to incorporate children's needs into guideline creation.
Purpose of the Study:
- To develop a tool to help guideline developers systematically consider pediatric populations.
- To explore methods for facilitating children's participation in guideline development.
- To improve the child-centeredness of clinical guidelines.
Main Methods:
- A three-phase multimethod sequential design was employed.
- Professionals involved in guideline development participated in interviews (n=12), questionnaires (n=60), and focus groups (n=11).
Main Results:
- A comprehensive understanding of factors influencing guideline applicability to children was achieved.
- A flowchart tool was developed to assist guideline developers in assessing the need for pediatric-specific guidelines.
- The flowchart guides users through critical questions for accurate assessment.
Conclusions:
- The flowchart serves as a reminder for developers to prioritize pediatric populations.
- It aids in ensuring clinical guidelines meet children's unique healthcare needs and perspectives.
- Facilitating child and parent participation is crucial for future child-centered guideline development.
Rationale, Aims And Objectives:
Children are not just small adults; they need to be diagnosed and treated in the context of their rapid growth and development. However, in guideline development, children's needs and interests are still overlooked. This study aims (1) to develop a tool that could stimulate guideline developers to take children into account on a more structural basis and (2) to explore how to facilitate children's participation in the process of guideline development.
Methods:
The method used was a three-phase multimethod sequential design. Professionals involved in guideline development participated in interviews (n = 12), filled in a questionnaire (n = 60) and/or participated in the focus group meeting (n = 11).
Results:
This study results in a comprehensive understanding of the considerations that professionals take into account when deciding whether guidelines need to apply to children specifically. This resulted in a tool that assists guideline developers to make this assessment more accurately. It takes the form of a flowchart that guides users through a series of critical questions.
Conclusions:
The flowchart reminds guideline developers to consider children as a particular patient population when prioritizing and demarcating new guideline topics. It will help to ensure that clinical guidelines address children's unique health care needs and perspectives. Facilitating children's and parents' participation in the process of guideline development is perceived as challenging; nevertheless, it should be the next step in making paediatric guidelines more child-centred and family-centred.
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