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Research priorities for pediatric pain management in emergency medicine
Daniel S Tsze1, Rebecca K Burger2, Eileen J Klein3
1Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA.
Insights
Developing a research agenda for pediatric emergency pain management is crucial. Ten high-priority questions were identified to guide future research and improve care for children experiencing acute pain.
Area of Science:
- Pediatric Emergency Medicine
- Pain Management Research
Background:
- Acute pain is common in children in emergency settings.
- Optimal pain management strategies require further investigation.
- Significant knowledge gaps hinder effective pediatric pain care.
Purpose of the Study:
- To develop a prioritized research agenda for pediatric pain management in emergency care.
- To identify key questions to guide future research efforts.
- To optimize pain management for children in emergency settings.
Main Methods:
- A modified Delphi approach was employed.
- A multidisciplinary expert group achieved consensus.
- Iterative refinement of research questions occurred over two rounds.
Main Results:
- Ten high-priority research questions were identified.
- Key areas include pain outcomes, analgesia optimization, and non-pharmacologic treatments.
- Other priorities encompass novel therapies, prehospital care, and health disparities.
Conclusions:
- The identified research questions will inform future studies.
- This agenda will guide researchers, funders, and policymakers.
- Advancing pediatric emergency pain management is the ultimate goal.
Background:
There is a high prevalence of acute pain in children cared for in the emergency care setting. However, there are still significant gaps in knowledge regarding optimal pain management. We aimed to develop a prioritized research agenda that identifies key questions for pediatric pain management in the emergency care setting that will guide future research and optimize care for children.
Methods:
We used a modified Delphi approach to achieve consensus among a multidisciplinary and geographically diverse expert advisory group. An initial list of 108 research questions was identified, with successive rounds of questionnaires conducted until there was a convergence of opinion or a point of diminishing returns was reached. The list was iteratively refined each round by advisory group members who ranked research questions and provided suggestions for potential additional questions and feedback regarding questions considered.
Results:
Twenty-nine advisory group members participated in the modified Delphi approach. Over the course of two rounds, we identified 10 research questions as the highest priority for future investigation. These questions included topics addressing short- and long-term outcomes related to inadequately assessed and treated pain, patient- and family-centered outcomes, optimizing analgesia in the emergency department (ED) and at home after discharge from the ED, nonpharmacologic/integrative treatments, novel analgesic treatments and strategies, children with difficult-to-treat pain, prehospital pain management, eliminating health disparities, opioid misuse/abuse, and dissemination and implementation.
Conclusions:
The 10 research questions identified as highest priority can inform future work by researchers, funders, policy makers, and other key decision makers who aim to meaningfully advance the management of pain in children cared for in the emergency care setting.
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