Designing a national pediatric critical care database: a Delphi consensus study

Canadian Journal of Anaesthesia · 12 authors, 9 centres

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TL;DR

This study used a modified Delphi consensus process with Canadian pediatric intensive care unit stakeholders to select 72 common data elements for a new national database. The core elements focused on clinical status and complex medical interventions, but did not achieve consensus for many social determinants of health.

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The study employed a multicentre modified Delphi method to develop consensus on common data elements for a national Canadian pediatric intensive care unit (PICU) database. A baseline survey was created by an initial panel, then iteratively refined over three rounds with a larger expert panel of 68 participants, including healthcare professionals and caregivers. Response rates across rounds were high (91%, 90%, 81%). The process resulted in consensus for 72 data elements across six domains, primarily reflecting clinical status and medical interventions. Limitations include potential measurement error (low test-retest reliability) and possible overrepresentation of physician perspectives, which may have influenced the exclusion of certain social determinant variables. The framework provides a methodology for creating standardized, consensus-driven clinical databases to support research and quality improvement.

STUDY TYPE

other

SPECIALTY

pediatrics

SUMMARISED BY

AI pipeline

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100% · A

ORIGINAL PAPER

PMC10202532

Designing a national pediatric critical care database: a Delphi consensus study

Canadian Journal of Anaesthesia

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ABSTRACT

Purpose We sought to describe the processes undertaken for the systematic selection and consensus determination of the common data elements for inclusion in a national pediatric critical care database in Canada. Methods We conducted a multicentre Delphi consensus study of Canadian pediatric intensive care units (PICUs) participating in the creation of a national database. Participants were PICU health care professionals, allied health professionals, caregivers, and other stakeholders. A dedicated panel group created a baseline survey of data elements based on literature, current PICU databases, and expertise in the field. The survey was then used for a Delphi iterative consensus process over three rounds, conducted from March to June 2021. Results Of 86 invited participants, 68 (79%) engaged and agreed to participate as part of an expert panel. Panel participants were sent three rounds of the survey with response rates of 62 (91%), 61 (90%) and 55 (81%), respectively. After three rounds, 72 data elements were included from six domains, mostly reflecting clinical status and complex medical interventions received in the PICU. While race, gender, and home region were included by consensus, variables such as minority status, indigenous status, primary language, and ethnicity were not. Conclusion We present the methodological framework used to select data elements by consensus for a national pediatric critical care database, with participation from a diverse stakeholder group of experts and caregivers from all PICUs in Canada. The selected core data elements will provide standardized and synthesized data for research, benchmarking, and quality improvement initiatives of critically ill children. Supplementary Information The online version contains supplementary material available at 10.1007/s12630-023-02480-9.

CITATION EXPORT

Nadia Roumeliotis, Joanne Ramil, Daniel Garros et al.. Designing a national pediatric critical care database: a Delphi consensus study. Canadian Journal of Anaesthesia. (2023). https://doi.org/10.1007/s12630-023-02480-9

AUTHORS

12 · 9 CENTRES

Nadia Roumeliotis, Joanne Ramil, Daniel Garros, Fuad Alnaji, Macha Bourdages, Valerie Brule, Karen Dryden-Palmer, Fiona Muttalib, Jessica Nicoll, Michael Sauthier, Srinivas Murthy, Patricia S. Fontela

1grid.14848.310000 0001 2292 3357Department of Pediatrics, Critical Care, CHU Sainte-Justine, University of Montreal, 3175 Chemin de la Cote-Sainte-Catherine, Montreal, QC H3T 1C5 Canada
2grid.416084.f0000 0001 0350 814XPediatric Intensive Care Unit, Montreal Children’s Hospital, Montreal, QC Canada
3grid.17089.370000 0001 2190 316XDivision of Critical Care, Department of Pediatrics, Stollery Children’s Hospital, University of Alberta, Edmonton, AB Canada
4grid.414148.c0000 0000 9402 6172Children’s Hospital of Eastern Ontario, Ottawa, ON Canada
5grid.23856.3a0000 0004 1936 8390Centre Mère Enfant Soleil du CHU de Québec, Université de Laval, Quebec, QC Canada
6grid.413983.4The Children’s Hospital of Winnipeg, Winnipeg, MB Canada
7grid.42327.300000 0004 0473 9646Pediatric Critical Care Unit, The Hospital for Sick Children, Toronto, ON Canada
8grid.414137.40000 0001 0684 7788Division of Pediatric Critical Care, BC Children’s Hospital, Vancouver, BC Canada
9grid.477424.60000 0004 0640 6407Pediatric Intensive Care Unit, Janeway Children’s Health and Rehabilitation Centre, St John’s, NL Canada