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Building global collaborative research networks in paediatric critical care: a roadmap
Luregn J Schlapbach1, Padmanabhan Ramnarayan2, Kristen S Gibbons3
1Department of Intensive Care and Neonatology, and Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland; Children's Intensive Care Research Program, Child Health Research Centre, University of Queensland, Brisbane, QLD, Australia.
Insights
Developing a roadmap is crucial for advancing paediatric critical care research. This plan addresses challenges like low patient numbers and funding to improve trials for critically ill children globally.
Area of Science:
- Critical Care Medicine
- Paediatric Health
- Health Policy Research
Background:
- Paediatric critical care units serve vulnerable children, but evidence for practice and policy is limited.
- Existing research faces challenges including low patient numbers, developmental heterogeneity, and funding disparities.
Purpose of the Study:
- To present a strategic roadmap for international paediatric critical care trials.
- To guide the development of robust research infrastructure and collaborative networks.
Main Methods:
- Convened a multidisciplinary group of 32 international paediatric critical care experts.
- Identified key challenges hindering paediatric critical care research.
- Proposed a seven-point strategic roadmap for improving trial design and conduct.
Main Results:
- Key challenges identified: low patient numbers, heterogeneity, consent issues, funding gaps, and infrastructure deficits.
- A seven-point roadmap was proposed, including network formation, toolkit development, data harmonization, and funder advocacy.
- The roadmap aims to facilitate the design and execution of trials for diverse paediatric populations.
Conclusions:
- Implementation of the proposed roadmap is essential for advancing paediatric critical care research.
- A collaborative, international approach is needed to overcome existing barriers.
- The roadmap provides a framework for conducting impactful trials to improve outcomes for critically ill children worldwide.
Abstract:
Paediatric critical care units are designed for children at a vulnerable stage of development, yet the evidence base for practice and policy in paediatric critical care remains scarce. In this Health Policy, we present a roadmap providing strategic guidance for international paediatric critical care trials. We convened a multidisciplinary group of 32 paediatric critical care experts from six continents representing paediatric critical care research networks and groups. The group identified key challenges to paediatric critical care research, including lower patient numbers than for adult critical care, heterogeneity related to cognitive development, comorbidities and illness or injury, consent challenges, disproportionately little research funding for paediatric critical care, and poor infrastructure in resource-limited settings. A seven-point roadmap was proposed: (1) formation of an international paediatric critical care research network; (2) development of a web-based toolkit library to support paediatric critical care trials; (3) establishment of a global paediatric critical care trial repository, including systematic prioritisation of topics and populations for interventional trials; (4) development of a harmonised trial minimum set of trial data elements and data dictionary; (5) building of infrastructure and capability to support platform trials; (6) funder advocacy; and (7) development of a collaborative implementation programme. Implementation of this roadmap will contribute to the successful design and conduct of trials that match the needs of globally diverse paediatric populations.
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