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Developing Consensus on Clinical Outcomes for Children with Mild Pneumonia: A Delphi Study.
Todd A Florin1, Joy Melnikow2, Melissa Gosdin2
1Division of Emergency Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago & Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Journal of the Pediatric Infectious Diseases Society
|January 10, 2023
Summary
Experts established consensus on key outcomes for pediatric community-acquired pneumonia (CAP) antibiotic trials. This aims to improve research consistency and clinical application for childhood CAP treatment.
Area of Science:
- Pediatric infectious diseases
- Clinical trial methodology
- Respiratory medicine
Background:
- Lack of consensus on outcomes hinders pediatric antibiotic trial harmonization and clinical translation.
- Expert consensus is needed to define study outcomes for pediatric mild community-acquired pneumonia (CAP).
Purpose of the Study:
- To develop expert consensus on study outcomes for clinical trials involving children with mild CAP.
- To establish standardized measures for clinical response and treatment failure in pediatric CAP research.
Main Methods:
- Delphi method employed with a multispecialty expert panel.
- Panelists ranked outcome importance over three rounds, with consensus defined as >70% agreement.
- Outcomes were refined based on expert suggestions and statistical feedback.
Main Results:
- Consensus reached on assessing treatment response/failure at a median of 3 days.
- Key clinical response outcomes include improvement in fever, work of breathing, and oral intake.
- Treatment failure outcomes encompass persistent fever, worsening respiratory distress, reduced intake, and interventions like IV fluids or antibiotic changes.
Conclusions:
- Multidisciplinary expert consensus provides objective, clinically translatable outcomes for pediatric CAP trials.
- Standardized outcomes will enhance research consistency and facilitate evidence-based clinical practice for childhood pneumonia.
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