Grant: Knowledge Synthesis Grant

<html> <body> <strong>Background:</strong> Corticosteroids, often referred to simply as "steroids", have been used to treat many respiratory conditions for over 60 years. There is growing evidence that steroids effectively manage the signs and symptoms associated with various pediatric respiratory illnesses, such as bronchiolitis, croup, tonsillitis, wheezing, and pneumonia.&nbsp;Despite this evidence and their widespread use in some populations, there is debate about using steroids in children and there is variation in whether or not individual physicians will use steroids to treat their pediatric patients. One of the main reasons for this inconsistency in practice is the concern that physicians have about the safety of steroids, especially when given to very young children.<br> <br> <strong>Objective:</strong> To conduct a systematic review of the literature examining clinically relevant safety outcomes related to acute single or recurrent corticosteroid use in infants (0-2 years of age) or preschoolers (2-6 year of age) with respiratory conditions.&nbsp;<br> <br> <strong>Methods:</strong> We will follow methodological standards for knowledge synthesis of safety outcomes. We will use a priori defined and well-accepted methods for: searching the literature; study selection, including specific eligibility criteria with respect to study design, population, interventions, and outcomes; data extraction; assessment of methodologic quality; data synthesis; and knowledge translation and dissemination. We will supplement standard systematic review methods with emerging methods specific to studying drug safety. For example, we will conduct a broad search including data from unpublished studies and regulatory agencies. We will include both trials and observational studies. We will employ novel methods for data analysis and presentation that incorporate indirect data and use data from non-comparative studies.<br> <br> <strong>Team Members:</strong> Our team involves Applicants with extensive methodological experience in conducting systematic reviews and clinical expertise in emergency medicine and respiratory illnesses. &nbsp;We have Knowledge Users that represent key national organizations that will assist with 1) focusing the scope of the review so that it is clinically relevant to the end-users, and 2) interpretation, presentation, and dissemination of results to a widespread audience. These organizations are Translating Emergency Knowledge for Kids (TREKK), a National Center of Excellence in Knowledge Mobilization for healthcare providers; Pediatric Emergency Research Canada (PERC), an organized network of pediatric emergency healthcare providers in Canada; and, the Emergency Medicine Division of the Canadian Paediatric Society.<br> <br> <strong>Knowledge Translation:&nbsp;</strong>We will use an integrated knowledge translation approach involving front-line clinicians and key national organizations to ensure that the results are relevant and widely disseminated. Knowledge Users will collaborate to determine the research questions and methodology, interpret findings, and help disseminate research results.&nbsp;<br> <br> <strong>Significance:</strong> The results of this comprehensive systematic review will help clarify the safety profile of steroids in the treatment of children with acute respiratory conditions. Moreover, the review will provide data necessary to inform appropriate and consistent practice in the care of children with acute respiratory illness. Dissemination of these results through the Knowledge Users will result in improved health outcomes while minimizing risk among this vulnerable population.</body> </html>