Paediatric Hospital Care PSP Question Verification form

The purpose of this Question Verification Form is to enable Priority Setting Partnerships (PSPs) to describe clearly how they checked that their questions were unanswered, before starting the interim prioritisation stage of the process.

The JLA requires PSPs to be transparent and accountable in defining their own scope and evidence checking process. This will enable researchers and other stakeholders to understand how individual PSPs decided that their questions were unanswered, and any limitations of their evidence checking.

Name of the PSP

Paediatric Hospital Care (Canada)

Please describe the scope of the PSP

The scope of the Pediatric Hospital Care PSP focuses on questions related to the clinical management of children (age between 0 and 18 years) hospitalized in a general pediatric inpatient unit (GPIU). Clinical management broadly refers to the diagnosis and treatment of conditions, which includes processes of care and specific conditions. While there is variation between Canadian hospitals regarding the types of conditions cared for in GPIUs, the PSP will focus on and include children with conditions where the management is led by general pediatricians. For example, children that are cared for in a GPIUs may be previously healthy and be hospitalized for acute, common illness (e.g. gastroenteritis) or the first presentation of a chronic condition (e.g. epilepsy). They may also be children with a chronic disease (e.g. asthma) or medical complexity (e.g. cerebral palsy and gastrostomy feeding) who are hospitalized for an acute, common illness or exacerbation of their chronic disease. The scope will include children with technology-dependent conditions.

The following topics are out of scope:

Questions related to the management of known mental health problems in-hospital (e.g. depression) which would require specialist input (e.g. psychiatry)
Questions related to chronic or pre-existing mental health problems of parents and caregivers.
Questions related to the care of children seen in specialized settings of care, including the pediatric intensive care unit (PICU), the neonatal intensive care unit (NICU), medical subspecialty units (e.g. oncology), psychiatric, and surgical inpatient units.
Questions related to etiology or prognosis
Questions related to healthcare organization and/or healthcare delivery.
Questions related to children who receive treatments outside of Canada.

Please provide a brief overview of your approach to checking whether the questions were unanswered

For reasons of practicality, highly focused and targeted searches were conducted to identify systematic reviews rather than a full systematic approach (which would have been impractical within the timeframe of the PSP). We also conducted focused keyword / free text only search that excluded the use of thesaurus terms.

Given the broad scope of our PSP, questions were considered unanswered if there was no systematic review, if a recent systematic review indicated insufficient evidence, or if there is insufficient evidence outlined in position statements from the Canadian Paediatric Society and American Academy of Pediatrics.

Please list the type(s) of evidence you used to verify your questions as unanswered

The evidence used to verify the questions are unanswered were as follows:

Systematic reviews
Clinical guidelines

Please list the sources that you searched in order to identify that evidence

The OVID interface at SickKids was used to search the following health and medical bibliographic databases:

MEDLINE
EMBASE
The Cochrane Library

Other resources included in the search were as follows:

Cumulative Index to Nursing and Allied Health Literature (CINAHL)
American Academy of Pediatrics (AAP) and Canadian Paediatric Society (CPS) Guidelines
NICE/SIGN guidelines
TRIP Database
Google Scholar
Epistemonikos

What search terms did you use?

Groups of the following sets were combined depending on the type of question:

Set 1: Used always

(systematic review* or meta analys* or meta-analys* or metaanaly* or meta synthes* or meta-synthes* or scoping review* or rapid review*).ti,ab.

Set 2: Used always

(pediatric* or paediatric* or child* or newborn* or infan* or baby or babies or neonat* or premature birth* or juvenile* or teen* or youth* or adolesc*).ti. or (pediatric* or paediatric* or child* or newborn* or infan* or baby or babies or neonat* or premature birth* or juvenile* or teen* or youth* or adolesc*).ab. /freq=2 or (child* or adolesc* or pediat* or paediat*).jn.

Set 3: Used always

(hospital* or inpatient* or NICU or PICU or intensive care unit or patient admission* or patient discharge* or medical admission unit or observation unit* or short stay unit* or length of stay or hospital stay* or emergency department or emergency ward or emergency room or emergency unit or "Accident and Emergency" or emergency unit* or healthcare setting? or health care setting? or healthcare facilit* or health care facilit*).ti,ab.

Set 4: Used always - words to reflect the concepts or focus in the questions – searched in document titles and abstracts.

Please describe the parameters of the search (eg time limits, excluded sources, country/language) and the rationale for any limitations

Eligibility criteria used for the inclusion of evidence was as follows:

To ensure retrieval of the most recent literature, searches were restricted to the last 10 years (2010 onwards).
Search limited to English only articles

Names of individuals who undertook the evidence checking

Dr. Rashid Anwar

On what date was the question verification process completed?

December 2020 to April 2021

Any other relevant information

N/A