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Accepted for/Published in: JMIR Research Protocols

Date Submitted: May 27, 2021
Date Accepted: Jul 30, 2021

The final, peer-reviewed published version of this preprint can be found here:

Pediatric Chronic Critical Illness: Protocol for a Scoping Review

Zorko D, McNally JD, Rochwerg B, Pinto N, Couban R, O’Hearn K, Choong K

Pediatric Chronic Critical Illness: Protocol for a Scoping Review

JMIR Res Protoc 2021;10(10):e30582

DOI: 10.2196/30582

PMID: 34596576

PMCID: 8520133

Pediatric Chronic Critical Illness: A Protocol for a Scoping Review

  • David Zorko; 
  • James Dayre McNally; 
  • Bram Rochwerg; 
  • Neethi Pinto; 
  • Rachel Couban; 
  • Katie O’Hearn; 
  • Karen Choong

ABSTRACT

Background:

Improvements in the delivery of intensive care have increased survival amongst even the most critically ill of children, leading to a growing number of children with chronic complex medical conditions in the pediatric intensive care unit (PICU). Some of these children are at significant risk of recurrent and prolonged critical illness, with higher morbidity and mortality—a unique population described as having chronic critical illness (CCI). To date pediatric CCI has been understudied and lacks an accepted consensus case definition.

Objective:

The purpose of this scoping review is to describe how pediatric CCI has been defined in the current literature, including the concept of prolonged PICU admission, and describe the methodologies used to develop any existing definitions. Secondary aims included describing patient characteristics and outcomes evaluated in included studies.

Methods:

We will search four electronic databases for studies that evaluated children admitted to any PICU identified with CCI. We will also search for studies describing prolonged PICU admission, as this concept is related to pediatric CCI. We will develop a hybrid crowdsourcing and machine-learning methodology to complete citation screening. Screening and data abstraction were performed by two reviewers, independently and in duplicate. Data abstraction will include details of population definitions, demographic and clinical characteristics of children with CCI, and outcomes evaluated.

Results:

The database search, crowd reviewer recruitment, and machine-learning algorithm development began in March 2021. Final data verification is ongoing. The analysis of the review is anticipated to be completed by Fall 2021.

Conclusions:

This scoping review will provide the most comprehensive epidemiologic evidence on pediatric CCI to date, an emerging area of pediatric intensive care research of high importance. The results of this review will help inform the development of a consensus case definition for pediatric CCI and set a priority agenda for future research. We will employ and demonstrate the validity of crowdsourcing and machine-learning methodologies to improve the efficiency of large scoping reviews. Clinical Trial: n/a for scoping reviews


 Citation

Please cite as:

Zorko D, McNally JD, Rochwerg B, Pinto N, Couban R, O’Hearn K, Choong K

Pediatric Chronic Critical Illness: Protocol for a Scoping Review

JMIR Res Protoc 2021;10(10):e30582

DOI: 10.2196/30582

PMID: 34596576

PMCID: 8520133

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