Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Division of Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA.
Pediatr Crit Care Med. 2022 Nov 1;23(11):893-907. doi: 10.1097/PCC.0000000000003055. Epub 2022 Aug 29.
To identify a PICU Core Outcome Measurement Set (PICU COMS), a set of measures that can be used to evaluate the PICU Core Outcome Set (PICU COS) domains in PICU patients and their families.
A modified Delphi consensus process.
Four webinars attended by PICU physicians and nurses, pediatric surgeons, rehabilitation physicians, and scientists with expertise in PICU clinical care or research ( n = 35). Attendees were from eight countries and convened from the Pediatric Acute Lung Injury and Sepsis Investigators Pediatric Outcomes STudies after PICU Investigators and the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network PICU COS Investigators.
Measures to assess outcome domains of the PICU COS are as follows: cognitive, emotional, overall (including health-related quality of life), physical, and family health. Measures evaluating social health were also considered.
None.
Measures were classified as general or additional based on generalizability across PICU populations, feasibility, and relevance to specific COS domains. Measures with high consensus, defined as 80% agreement for inclusion, were selected for the PICU COMS. Among 140 candidate measures, 24 were delineated as general (broadly applicable) and, of these, 10 achieved consensus for inclusion in the COMS (7 patient-oriented and 3 family-oriented). Six of the seven patient measures were applicable to the broadest range of patients, diagnoses, and developmental abilities. All were validated in pediatric populations and have normative pediatric data. Twenty additional measures focusing on specific populations or in-depth evaluation of a COS subdomain also met consensus for inclusion as COMS additional measures.
The PICU COMS delineates measures to evaluate domains in the PICU COS and facilitates comparability across future research studies to characterize PICU survivorship and enable interventional studies to target long-term outcomes after critical illness.
确定一个儿科重症监护室核心结局测量集（PICU COMS），这是一组可用于评估儿科重症监护室患者及其家属的儿科重症监护室核心结局集（PICU COS）领域的测量方法。
改良德尔菲共识流程。
儿科重症监护室医生和护士、儿科外科医生、康复医生以及在儿科重症监护室临床护理或研究方面具有专业知识的科学家参加了 4 次网络研讨会（n = 35）。与会者来自 8 个国家，由儿科急性肺损伤和脓毒症研究人员儿科结局研究后儿科重症监护室研究人员和 Eunice Kennedy Shriver 国立儿童健康与人类发育研究所合作儿科危重病护理研究网络儿科重症监护室 COS 研究人员召集。
用于评估 PICU COS 结局领域的测量方法如下：认知、情绪、整体（包括健康相关生活质量）、身体和家庭健康。还考虑了评估社会健康的测量方法。
无。
根据在儿科重症监护室人群中的普遍性、可行性以及与特定 COS 领域的相关性，将测量方法分为一般或附加。对于纳入的测量方法，共识度高（即 80%的人同意纳入）。在 140 项候选测量方法中，有 24 项被确定为通用（广泛适用），其中 10 项达成共识，纳入 COMS（7 项患者导向，3 项家庭导向）。这 7 项患者测量方法中的 6 项适用于最广泛的患者、诊断和发育能力范围。所有方法均在儿科人群中进行了验证，并具有规范的儿科数据。另外 20 项侧重于特定人群或对 COS 子域进行深入评估的测量方法也达成共识，纳入 COMS 附加测量方法。
PICU COMS 确定了评估 PICU COS 领域的测量方法，便于在未来的研究中进行比较，以描述儿科重症监护室的生存情况，并使干预研究能够针对重症疾病后的长期结局。
