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Rapid response in the COVID-19 pandemic: a Delphi study from the European Pediatric Dialysis Working Group.

ABSTRACT: BACKGROUND:COVID-19 was declared a global health emergency. Since children are less than 1% of reported cases, there is limited information to develop evidence-based practice recommendations. The objective of this study was to rapidly gather expert knowledge and experience to guide the care of children with chronic kidney disease during the COVID-19 pandemic. METHODS:A four-round multi-center Delphi exercise was conducted among 13 centers in 11 European countries of the European Pediatric Dialysis Working Group (EPDWG) between March, 16th and 20th 2020. Results were analyzed using a mixed methods qualitative approach and descriptive statistics. RESULTS:Thirteen COVID-19 specific topics of particular need for guidance were identified. Main themes encompassed testing strategies and results (n?=?4), changes in use of current therapeutics (n?=?3), preventive measurements of transmission and management of COVID-19 (n?=?3), and changes in standard clinical care (n?=?3). Patterns of center-specific responses varied according to regulations and to availability of guidelines. CONCLUSIONS:As limited quantitative evidence is available in real time during the rapid spread of the COVID-19 pandemic, qualitative expert knowledge and experience represent the best evidence available. This Delphi exercise demonstrates that use of mixed methodologies embedded in an established network of experts allowed prompt analysis of pediatric nephrologists' response to COVID-19 during this fast-emerging public health crisis. Such rapid sharing of knowledge and local practices is essential to timely and optimal guidance for medical management of specific patient groups in multi-country health care systems such as those of Europe and the US.

SUBMITTER: Eibensteiner F

PROVIDER: S-EPMC7230035 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Rapid response in the COVID-19 pandemic: a Delphi study from the European Pediatric Dialysis Working Group.

Eibensteiner Fabian F Ritschl Valentin V Ariceta Gema G Jankauskiene Augustina A Klaus Günter G Paglialonga Fabio F Edefonti Alberto A Ranchin Bruno B Schmitt Claus Peter CP Shroff Rukshana R Stefanidis Constantinos J CJ Walle Johan Vande JV Verrina Enrico E Vondrak Karel K Zurowska Aleksandra A Stamm Tanja T Aufricht Christoph C

Pediatric nephrology (Berlin, Germany) 20200517 9

<h4>Background</h4>COVID-19 was declared a global health emergency. Since children are less than 1% of reported cases, there is limited information to develop evidence-based practice recommendations. The objective of this study was to rapidly gather expert knowledge and experience to guide the care of children with chronic kidney disease during the COVID-19 pandemic.<h4>Methods</h4>A four-round multi-center Delphi exercise was conducted among 13 centers in 11 European countries of the European P ...[more]

PMID: 32418146

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Project description:BackgroundThe COVID-19 pandemic has hit all corners of the world, challenging governments to act promptly in controlling the spread of the pandemic. Due to limited resources and inferior technological capacities, developing countries including Vietnam have faced many challenges in combating the pandemic. Since the first cases were detected on 23 January 2020, Vietnam has undergone a 3-month fierce battle to control the outbreak with stringent measures from the government to mitigate the adverse impacts. In this study, we aim to give insights into the Vietnamese government's progress during the first three months of the outbreak. Additionally, we relatively compare Vietnam's response with that of other Southeast Asia countries to deliver a clear and comprehensive view on disease control strategies.MethodsThe data on the number of COVID-19 confirmed and recovered cases in Vietnam was obtained from the Dashboard for COVID-19 statistics of the Ministry of Health (https://ncov.vncdc.gov.vn/). The review on Vietnam's country-level responses was conducted by searching for relevant government documents issued on the online database 'Vietnam Laws Repository' (https://thuvienphapluat.vn/en/index.aspx), with the grey literature on Google and relevant official websites. A stringency index of government policies and the countries' respective numbers of confirmed cases of nine Southeast Asian countries were adapted from the Oxford COVID-19 Government Response Tracker (https://www.bsg.ox.ac.uk/research/research-projects/coronavirus-government-response-tracker). All data was updated as of 24 April 2020.ResultsPreliminary positive results have been achieved given that the nation confirmed no new community-transmitted cases since 16 April and zero COVID-19 - related deaths throughout the 3-month pandemic period. To date, the pandemic has been successfully controlled thanks to the Vietnamese government's prompt, proactive and decisive responses including mobilization of the health care systems, security forces, economic policies, along with a creative and effective communication campaign corresponding with crucial milestones of the epidemic's progression.ConclusionsVietnam could be one of the role models in pandemic control for low-resource settings. As the pandemic is still ongoing in an unpredictable trajectory, disease control measures should continue to be put in place in the foreseeable short term.

Project description:Prior to the COVID-19 pandemic, the majority of clinical trial activity took place face to face within clinical or research units. The COVID-19 pandemic resulted in a significant shift towards trial delivery without in-person face-to-face contact or "Remote Trial Delivery". The National Institute of Health Research (NIHR) assembled a Remote Trial Delivery Working Group to consider challenges and enablers to this major change in clinical trial delivery and to provide a toolkit for researchers to support the transition to remote delivery. The NIHR Remote Trial Delivery Working Group evaluated five key domains of the trial delivery pathway: participant factors, recruitment, intervention delivery, outcome measurement and quality assurance. Independent surveys were disseminated to research professionals, and patients and carers, to ascertain benefits, challenges, pitfalls, enablers and examples of good practice in Remote Trial Delivery. A toolkit was constructed to support researchers, funders and governance structures in moving towards Remote Trial Delivery. The toolkit comprises a website encompassing the key principles of Remote Trial Delivery, and a repository of best practice examples and questions to guide research teams. The patient and carer survey received 47 respondents, 34 of whom were patients and 13 of whom were carers. The professional survey had 115 examples of remote trial delivery practice entered from across England. Key potential benefits included broader reach and inclusivity, the ability for standardisation and centralisation, and increased efficiency and patient/carer convenience. Challenges included the potential exclusion of participants lacking connectivity or digital skills, the lack of digitally skilled workforce and appropriate infrastructure, and validation requirements. Five key principles of Remote Trial Delivery were proposed: national research standards, inclusivity, validity, cost-effectiveness and evaluation of new methodologies. The rapid changes towards Remote Trial Delivery catalysed by the COVID-19 pandemic could lead to sustained change in clinical trial delivery. The NIHR Remote Trial Delivery Working Group provide a toolkit for researchers recommending five key principles of Remote Trial Delivery and providing examples of enablers.

Dataset Information

Rapid response in the COVID-19 pandemic: a Delphi study from the European Pediatric Dialysis Working Group.

Publications

Rapid response in the COVID-19 pandemic: a Delphi study from the European Pediatric Dialysis Working Group.

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