Author: Marian Chandler

Current status:

• Recruiting at 11/11 PREDICT sites, 326 patients enrolled to date.
• US recruiting at 20 sites, with 2900 patients recruited so far. Canada are recruiting at 10 site, with 137 enrolments so far.
• Townsville University Hospital will commence recruitment for PROMPT Bolus in June 2023, awaiting local governance approval.
• International DSMB will meet for the second time- June 2023
• Protocol amendment lowering the age of inclusion has been implemented- current inclusion criteria is aged 2 months to less than 18 years of age.
• Quarterly newsletters are sent to all sites, with data queries and study compliance
• Waiver of consent to randomised followed by written consent to continue remains in place will nil issues.
• Yearly site audits for 2023 will commence in May 2023- we look forward to meeting with all of the site staff.

The PREDICT members meeting has been moved to 15th November 2023.  An amended calendar invite has been forwarded to all members.  Please accept the invite to ensure you have the correct date in your calendar.  The event will be held in Melbourne at the Murdoch Children’s Research Institute.

Planning is under way for a two day face-to-face Research Nurse/Assistant education session to be held at the RCH Melbourne on 24th and 25th July 2023. Studies to be covered are:

• Mental Health Prospective Observational Study
• Asthma Prospective Study
• Febrile Convulsions (FEBCON)
• CHOICE UTI
• SPASMs

NB. The SONIC, PROMPT Bolus/Sentinel and PEACHY O & M Co-ordinators will also be present at a designated time during the two days to answer any questions you may have about these studies that are now well underway.

We have run similar education days in the past and they have been extremely successful.  We highly recommend that you attend if working on these studies. We will cover all study related topics including governance applications, study oversight, in depth study specific education, databases, legal contracts, GCP and recruitment.

Please save these dates in your diaries. Formal invitations are being sent to site co-ordinators soon. This will include detailed information on funding and the process for booking flights and accommodation.

Our “Getting to Know You” segment ensures PREDICT members are aware of new members, their interests and areas of expertise and where they are located.

This month we introduce Tahnee Dunlop from Warrnambool Healthcare and Deakin University.

“I work at South West Healthcare Warrnambool, a regional hospital in southwestern Victoria on Gunditjmara country, at the end of the Great Ocean Road. I work as an ED consultant in a mixed ED as our PEM lead, and also work in rural emergency medicine at Deakin University. I have been the site lead for Warrnambool in the Kids Are Not Okay project and look forward to future collaborations with PREDICT.”

Welcome to PREDICT Tahnee.

The Kids are Not Ok: A Delphi Study to identify consensus research priorities and core outcome sets in paediatric emergency mental health presentations

Aim:

To determine a prioritised list of research questions and identify a set of core clinical and mental health outcomes for children and adolescents presenting to the ED with mental health concerns.

Participants:

Children/young people under 18 who attended ED with mental health concerns and their parents/carers. Doctors, nurses, mental health clinicians, police, paramedics, schoolteachers, school counsellors, hospital security.

Current status:

We have completed the three planned survey rounds; however, a fourth round will be introduced to complete the project. Nearly there!

Survey Round 1

• 184 participants (provided complete and partial responses)
  –  36 patient/carers from 12 participating hospital sites (VIC, QLD and SA)
  –  148 clinician and community-based participants (VIC, QLD, SA, WA and TAS)
• 989 free-text comments
  –  Service (a comment on service / patient experience / general comments)
  –  Data (a list of things that can be collected about patients who arrive to ED)
  –  Outcome (something that can be measured after ED attendance)
  –  Question (something that could be turned into a research question)

Survey Round 2

• 267 items from Survey Round 1 were grouped into topics (e.g., ED re-presentation, length of stay, QOL etc)
• Participants rated items on a 9-point ordinal scale (“not important to extremely important”) and space was provided for optional free text responses for each choice
• If items were rated 7 to 9 (on the 9-point Likert scale) by 50% or more participants and 1 to 3 by no more than 15% of participants in at least one stakeholder group they were included in Survey Round 3
• 62 responses in total (25 complete and 37 incomplete responses) from 57 clinician/community-based services and 5 patient/carer respondents

Survey Round 3

• 127 items were presented for survey round 3.  Grouped and rated as for round 2.
• A consensus was defined when the following criteria were met (1) 70% of participants scoring outcomes as 7 to 9 and 15% or less scoring 1 to 3 by both stakeholder groups; or (2) 90% or more scoring 7 to 9 from either stakeholder group.
• 29 responses in total (20 complete and 9 incomplete responses) from 26 clinician/community-based services and 3 patient/carer respondents. The rating for 9 items were inconclusive.

Survey Round 4

• Instead of convening a consensus meeting for the remaining nine items, we will (after consultation with the steering group) distribute a fourth survey.

Our “Getting to Know You” segment ensures PREDICT members are aware of new members, their interests and areas of expertise and where they are located.

This month we introduce Medha Rao from Starship Children’s Hospital in Auckland, NZ.

“I am the CED Research Nurse Co-ordinator at the Children’s Emergency Department, Starship Hospital in Auckland, New Zealand. I am very honoured to be a part of the PREDICT Network. In addition to overseeing the running of the studies and the CED Research Team, I am also responsible for recruiting participants, participant follow up, data collection and data entry. At Starship, we have a few studies currently underway – the BIPED study, PRoMPT Bolus, SENTINEL and SONIC. I feel privileged to be a part of these global studies contributing to better health outcomes in the paediatric populations”.

Welcome to PREDICT Medha.

Our “Getting to Know You” segment ensures PREDICT members are aware of new members, their interests and areas of expertise and where they are located.

This month we introduce Giles Barrington from Royal Hobart Hospital.

“The Royal Hobart Hospital is the major tertiary referral centre for Tasmania., the Emergency Department sees over 75000 presentations a year and services a diverse and complex patient population. I am a clinical nurse as well as the Research and Performance Improvement Nurse for the ED and work under the supervision of the Director of Emergency Research and the Tasmanian Emergency Research Group (TASER). My duties are to assist with the management, undertaking, and monitoring of research activities within our department. My current research focus is on factors influencing the prescription of opioid analgesics on discharge from the ED and interventions to reduce opioid divergence and harm post discharge. We have collaborated with PREDICT on several research projects I am excited to become a new member of this international research network”

Welcome to PREDICT Giles.

All new PREDICT projects need to consider how families can be engaged in their research design, operations and dissemination.

See the resources on our website detailing the “how to” and compensation guidelines at: https://www.predict.org.au/family-engagement/

We will be adding to these resources over the coming year.

 

For further information, please contact the PREDICT network Co-ordinator, Catherine.wilson@mcri.edu.au

Congratulations to the following PREDICT authors:

Franklin D, Babl FE, George S, Oakley E, Borland ML, Neutze J, Acworth J, Craig S, Jones M, Gannon B, Shellshear D, McCay H, Wallace A, Hoeppner T, Wildman M, Mattes J, Pham TMT, Miller L, Williams A, O’Brien S, Lawrence S, Bonisch M, Gibbons K, Moloney S, Waugh J, Hobbins S, Grew S, Fahy R, Dalziel SR, Schibler A. Effect of Early High-Flow Nasal Oxygen vs Standard Oxygen Therapy on Length of Hospital Stay in Hospitalized Children With Acute Hypoxemic Respiratory Failure: The PARIS-2 Randomized Clinical Trial. JAMA. 2023 Jan 17;329(3):224-234. doi: 10.1001/jama.2022.21805. PMID: 36648469 Clinical Trial. 

Franklin D, Babl FE, Neutze J, Craig S, Oakley E, Furyk J, Frampton CM, Hasan N, Pham TM, Miller L, Fraser JF, Dalziel SR, Schibler A. Predictors of intensive care admission in hypoxemic bronchiolitis infants Secondary Analysis of a Randomized Trial. J Pediatr. 2022 Dec 14:S0022-3476(22)01122-2. doi: 10.1016/j.jpeds.2022.12.006. Epub ahead of print. PMID: 36528052.

Gray C, Xu Y, Babl FE, Dalziel SR, Powell CVE, Chong S, Roland D, Lyttle MD, Fernandes RM, Benito J, Johnson M, Yock-Corrales A, Santhanam I, Schuh S, Cheema B, Couper J, Craig S, On behalf of the Pediatric Emergency Research Network (PERN). International perspective on research priorities and outcome measures of importance in the care of children with acute exacerbations of asthma: a qualitative interview study. BMJ Open Resp Res. 2023;10:e001502. doi:10.1136/bmjresp-2022-001502.

 

 

The PARIS-2 paper entitled “Effect of Early High-Flow Nasal Oxygen vs Standard Oxygen Therapy on Length of Hospital Stay in Hospitalized Children With Acute Hypoxemic Respiratory Failure – The PARIS-2 Randomized Clinical Trial” has just been published in the Journal of the American Medical Association (JAMA) to much fanfare.

The story has been taken up by a range of media outlets, both national and international.

The significance of this study feeds into PREDICT member Dr Donna Franklin’s new project “PARIS on Country” on which she is Chief Investigator. Donna’s team will work in collaboration with the Wesley Research Institute to promote health equity and reduce transfers of sick children with respiratory disease to city hospitals in 18 rural and remote hospitals.”  Read the full story published on the Wesley Research Institute website here.

Big congratulations to Donna Franklin and the PARIS team.