Developing Consensus on Clinical Outcomes for Children with Mild Pneumonia: A Delphi Study.
Developing Consensus on Clinical Outcomes for Children with Mild Pneumonia: A Delphi Study.
复制标题
就轻度肺炎儿童的临床结果达成共识：德尔菲研究。
DOI：
10.1093/jpids/piac123
复制
发表时间：
2023
影响因子：
3.2
通讯作者：
Shah,
中科院分区：
文献类型：
--
作者：
Florin,ToddA;Melnikow,Joy;Gosdin,Melissa;Ciuffetelli,Ryan;Benedetti,Jillian;Ballard,Dustin;Gausche-Hill,Marianne;Kronman,MatthewP;Martin,LisaA;Mistry,RakeshD;Neuman,MarkI;Palazzi,DebraL;Patel,SameerJ;Self,WesleyH;Shah,
儿科抗生素试验结果缺乏共识是研究协调和临床转化的主要障碍。我们寻求发展专家共识的临床试验的儿童轻度社区获得性肺炎（CAP）的研究成果。MethodsAppliing的德尔菲法，一个多专业的专家小组排名的重要性，各种成分的临床反应和治疗失败的结果，在儿童轻度CAP用于研究。在第一轮会议期间，小组成员在开放式答复中提出了其他成果，这些成果被添加到随后几轮建立共识的工作中。对于第2轮和第3轮，向小组成员提供他们自己在前一轮中对每个项目的先前回答和汇总统计。共识被定义为>70% agreement.ResultsThe专家小组确定，响应和失败的治疗应在中位数为3天后开始解决。发热、呼吸功、呼吸困难、无发热时呼吸急促、经口摄入和活动的完全或实质性改善应作为充分临床应答结局的组成部分。临床体征和症状，包括持续或恶化的发热，呼吸工作，减少口服摄入量应包括在治疗失败的结果。干预措施，包括接收胃肠外液体，补充氧气，需要高流量鼻插管氧疗，并在处方抗生素的变化也应考虑在治疗失败outcomes.ConclusionsClinical反应和治疗失败的结果，这一多学科的专家小组的共识，可用于儿科CAP研究，提供客观的数据translatable到临床实践。
BackgroundThe absence of consensus for outcomes in pediatric antibiotic trials is a major barrier to research harmonization and clinical translation. We sought to develop expert consensus on study outcomes for clinical trials of children with mild community-acquired pneumonia (CAP).MethodsApplying the Delphi method, a multispecialty expert panel ranked the importance of various components of clinical response and treatment failure outcomes in children with mild CAP for use in research. During Round 1, panelists suggested additional outcomes in open-ended responses that were added to subsequent rounds of consensus building. For Rounds 2 and 3, panelists were provided their own prior responses and summary statistics for each item in the previous round. The consensus was defined by >70% agreement.ResultsThe expert panel determined that response to and failure of treatment should be addressed at a median of 3 days after initiation. Complete or substantial improvement in fever, work of breathing, dyspnea, tachypnea when afebrile, oral intake, and activity should be included as components of adequate clinical response outcomes. Clinical signs and symptoms including persistent or worsening fever, work of breathing, and reduced oral intake should be included in treatment failure outcomes. Interventions including receipt of parenteral fluids, supplemental oxygen, need for high-flow nasal cannula oxygen therapy, and change in prescription of antibiotics should also be considered in treatment failure outcomes.ConclusionsClinical response and treatment failure outcomes determined by the consensus of this multidisciplinary expert panel can be used for pediatric CAP studies to provide objective data translatable to clinical practice.