In a comment published in The Lancet Child & Adolescent Health, NOMIS researcher Luregn Schlapbach and colleague Mark J. Peters address the serious issues related to a lack of high-grade evidence for diagnostic and therapeutic practices in the UK’s neonatal and pediatric intensive care units.
More than 100 000 infants and children are admitted to neonatal and paediatric intensive care units in the UK annually. Infections and sepsis remain a leading cause of admission, short-term and long-term morbidity, and mortality in this patient group. Yet, the majority of diagnostic and therapeutic practices in this setting are not based on high-grade evidence. This exposes children to suboptimal decision making and ineffective or even harmful interventions. The cost to patients, families, and society of this evidence deficit is unknown. Is this simply attributable to the innate challenges of performing clinical trials (cost, time, and availability of appropriately trained staff) or rather to the specific critical care setting (time-sensitive interventions, safety concerns, acceptability to staff and parents, and the complexity of consent under acute stress)?
Continue reading The Lancet Child & Adolescent Health publication: Pragmatic trials for critical illness in neonates and children
