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Designing a national pediatric critical care database: a Delphi consensus study
Nadia Roumeliotis1, Joanne Ramil2, Daniel Garros3
1Department of Pediatrics, Critical Care, CHU Sainte-Justine, University of Montreal, 3175 Chemin de la Cote-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada. nadia.roumeliotis@gmail.com.
Insights
A national pediatric critical care database in Canada was developed using a Delphi consensus study. This process identified 72 core data elements for research and quality improvement in pediatric intensive care units (PICUs).
Area of Science:
- Pediatric Critical Care Medicine
- Health Informatics
- Data Standardization
Background:
- Developing a national pediatric critical care database is crucial for improving care.
- Standardized data elements are needed for research, benchmarking, and quality improvement.
Purpose of the Study:
- To describe the systematic selection and consensus process for common data elements for a Canadian national pediatric critical care database.
- To establish a standardized set of data for pediatric intensive care units (PICUs).
Main Methods:
- A multicentre Delphi consensus study involving Canadian PICUs was conducted.
- Expert panels of healthcare professionals, caregivers, and stakeholders participated in three survey rounds.
- A baseline survey was developed from literature, existing databases, and expert knowledge.
Main Results:
- 68 out of 86 invited participants (79%) engaged in the expert panel.
- Three rounds of surveys achieved high response rates (81-91%).
- 72 data elements across six domains were selected, focusing on clinical status and interventions; demographic variables like race and gender were included, but not minority status or ethnicity.
Conclusions:
- A methodological framework was established for consensus-based data element selection for a national pediatric critical care database.
- The selected core data elements will facilitate standardized data for research, benchmarking, and quality improvement in pediatric critical care.
- Diverse stakeholder participation ensured comprehensive and relevant data element selection.
Purpose:
We sought to describe the processes undertaken for the systematic selection and consensus determination of the common data elements for inclusion in a national pediatric critical care database in Canada.
Methods:
We conducted a multicentre Delphi consensus study of Canadian pediatric intensive care units (PICUs) participating in the creation of a national database. Participants were PICU health care professionals, allied health professionals, caregivers, and other stakeholders. A dedicated panel group created a baseline survey of data elements based on literature, current PICU databases, and expertise in the field. The survey was then used for a Delphi iterative consensus process over three rounds, conducted from March to June 2021.
Results:
Of 86 invited participants, 68 (79%) engaged and agreed to participate as part of an expert panel. Panel participants were sent three rounds of the survey with response rates of 62 (91%), 61 (90%) and 55 (81%), respectively. After three rounds, 72 data elements were included from six domains, mostly reflecting clinical status and complex medical interventions received in the PICU. While race, gender, and home region were included by consensus, variables such as minority status, indigenous status, primary language, and ethnicity were not.
Conclusion:
We present the methodological framework used to select data elements by consensus for a national pediatric critical care database, with participation from a diverse stakeholder group of experts and caregivers from all PICUs in Canada. The selected core data elements will provide standardized and synthesized data for research, benchmarking, and quality improvement initiatives of critically ill children.
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