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Research capacity and limitations in Canadian paediatric emergency departments: An observational study on biomarker
Elena Mitevska1, Beata Mickiewicz2, Leslie Boisvert3
1Department of Pediatrics, University of Alberta, Edmonton, Alberta.
Insights
Paediatric research capacity in Canadian emergency departments (EDs) is limited, particularly for after-hours sample processing and patient enrollment. Investing in infrastructure and human resources is crucial for improving child health outcomes.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Research Operations
- Health Services Research
Background:
- Paediatric research is vital for advancing child health diagnoses and treatments but has historically faced under-prioritization.
- The PRIMED study aimed to profile children with appendicitis and assess bio-profiles as a clinical prediction tool.
- This study evaluated clinical research capacity in Canadian paediatric emergency departments (EDs), identifying implementation challenges and solutions.
Purpose of the Study:
- To assess the clinical research capacity of Canadian paediatric emergency departments (EDs) for the PRIMED study.
- To identify challenges faced during the implementation of paediatric research protocols.
- To describe strategies employed to enhance local research capacity.
Main Methods:
- Eleven Canadian paediatric EDs provided demographic, administrative, and resource availability data.
- Data on laboratory processing and human resource availability were collected during study enrollment.
- Descriptive statistics were used to summarize the collected data.
Main Results:
- Less than half (45%) of sites had 24-hour laboratory access for research samples.
- 36% of sites only enrolled patients during business hours, with no nighttime coverage for enrollment or sample collection.
- 55% of sites developed innovative solutions, such as on-call schedules and dedicated research coordinators, to overcome resource limitations.
Conclusions:
- Significant gaps in clinical research capacity persist in academic paediatric EDs despite dedicated efforts.
- Investment in infrastructure and human resources is essential to bolster after-hours research capabilities.
- Enhancing research capacity is critical for optimizing child health and wellness outcomes.
Background:
Paediatric research is essential to acquire effective diagnoses and treatment for children, but it has historically been under-prioritized. The PRIMED study aimed to characterize the bio-profiles of children with appendicitis and investigate their use as a clinical prediction tool. We evaluated the clinical research capacity of several Canadian paediatric emergency departments (EDs) and described both the challenges experienced in the implementation of the PRIMED study and the strategies which were used to improve local research capacity.
Methods:
Eleven paediatric EDs across Canada provided basic demographic and administrative data along with laboratory- and human-resource availability during the PRIMED study enrollment. Data were summarized using descriptive statistics.
Results:
Fewer than half of the study sites (5/11, 45%) had access to a laboratory that would process research samples 24 hours per day. Four study sites (36%) only enrolled patients during business hours (8:00-17:00). There was no nighttime coverage for patient enrollment and sample collection. Only three study sites (27%) had enrollment hours that captured over 75% of the potential study participants. Over half of the study sites (6/11, 55%) developed novel processes to enable study success, for example, creating graduate student on-call schedules and hiring bioscience-trained site coordinators to process samples.
Interpretation:
Despite site-specific efforts to overcome resource barriers, the gap in clinical research capacity at academic paediatric EDs remains a significant concern. University research institutes and paediatric hospitals should invest in infrastructure and human resources to increase after-hours research capacity to optimize child health and wellness outcomes.
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