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ESPGHAN and NASPGHAN 2023 protocol for paediatric FAPD treatment guidelines (standard operating procedure)
Morris Gordon1, Marc A Benninga2, Rachel Borlack3
1University of Central Lancashire, Preston, UK Mgordon@uclan.ac.uk.
Insights
This study outlines a new international treatment guideline for pediatric functional abdominal pain disorders (FAPDs), focusing on functional abdominal pain-not otherwise specified (FAP-NOS), irritable bowel syndrome (IBS), and abdominal migraine (AM). The guideline development will use the GRADE approach and a Delphi process for consensus.
Area of Science:
- Pediatric Gastroenterology
- Clinical Psychology
- Evidence-Based Medicine
Background:
- No international guidelines exist for pediatric functional abdominal pain disorders (FAPDs).
- FAPDs include functional abdominal pain-not otherwise specified (FAP-NOS), irritable bowel syndrome (IBS), functional dyspepsia, and abdominal migraine (AM).
- A comprehensive treatment guideline is needed to address the diverse therapies available for FAPDs.
Purpose of the Study:
- To develop an international treatment guideline for pediatric functional abdominal pain disorders (FAPDs).
- The guideline will focus on FAP-NOS, IBS, and AM.
- To systematically review and synthesize available treatment options for these conditions.
Main Methods:
- The guideline development will follow the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
- A Guideline Development Group (GDG) comprising pediatric gastroenterologists and a clinical psychologist will be formed.
- A Delphi process will be used for consensus on treatment options and recommendations, supported by a technical evidence review of randomized controlled trials using the Cochrane tool.
Main Results:
- The study protocol outlines a systematic approach to guideline development.
- Consensus will be reached on treatment options and recommendations through a Delphi process.
- Evidence from randomized controlled trials will be critically appraised for risk of bias.
Conclusions:
- This manuscript presents the prospective operating procedure and technical summary protocol for developing an international treatment guideline for pediatric functional abdominal pain disorders.
- The proposed methodology ensures a rigorous and evidence-based approach to guideline creation.
- The guideline aims to provide clear, actionable recommendations for managing FAPDs in children.
Introduction:
To date, no international guidelines have been published for the treatment of paediatric functional abdominal pain disorders (FAPDs), subcategorised into functional abdominal pain-not otherwise specified (FAP-NOS), irritable bowel syndrome (IBS), functional dyspepsia and abdominal migraine (AM). We aim for a treatment guideline, focusing on FAP-NOS, IBS and AM, that appreciates the extensive array of available therapies in this field. We present the prospective operating procedure and technical summary protocol in this manuscript.
Methods:
Grading of Recommendations, Assessment, Development and Evaluation (GRADE) will be followed in the development of the guideline, following the approach as laid out in the GRADE handbook, supported by the WHO. The Guideline Development Group (GDG) is formed by paediatric gastroenterologists from both the European Society for Pediatric Gastroenterology, Hepatology and Nutrition, as well as the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Also, one clinical psychologist with expertise in FAPDs is a voting member in the GDG. A final consensus list of treatment options is translated into 'patient, intervention, comparison, outcome' format options. Prospective agreement on the magnitude of health benefits or harms categories was reached through a Delphi process among the GDG to support grading of the literature.There will be a detailed technical evidence review with randomised controlled trial data that will be judged for risk of bias with the Cochrane tool. Recommendations are preferably based on GRADE but could also be best practice statements following the available evidence. A full Delphi process will be used to make recommendations using online response systems. This set of procedures has been approved by all members of the GDG.
