Pediatric Chronic Critical Illness: Protocol for a Scoping Review

Area of Science:

• Pediatric critical care medicine
• Health services research
• Medical informatics

Background:

• Increased survival in pediatric intensive care units (PICUs) leads to more children with chronic complex medical conditions.
• A subset of these children face recurrent critical illness, high morbidity, and mortality, termed chronic critical illness (CCI).
• Pediatric CCI remains understudied with no universally accepted case definition.

Purpose of the Study:

• To conduct a scoping review of how pediatric chronic critical illness (CCI) is defined in existing literature.
• To analyze methodologies used for developing current definitions and identify patient characteristics and outcomes studied.
• To inform the development of a consensus case definition for pediatric CCI.

Main Methods:

• Systematic search of four electronic databases for studies on pediatric CCI and prolonged PICU admission.
• Hybrid crowdsourcing and machine learning (ML) methodology for citation screening.
• Independent, duplicate screening and data abstraction by two reviewers, focusing on definitions, demographics, clinical characteristics, and outcomes.

Main Results:

• Database searching, crowd reviewer recruitment, and ML algorithm development commenced in March 2021.
• Citation screening and data abstraction were completed by April 2021.
• Final data verification is ongoing, with analysis and results expected by fall 2021.

Conclusions:

• The scoping review will delineate existing definitions of pediatric CCI and associated patient characteristics.
• Findings will guide the creation of a consensus case definition for pediatric CCI and prioritize future research.
• The study will validate the use of crowdsourcing and ML for efficient large-scale scoping reviews.