As a modern practitioner, I live in the era of Evidence-based practice. Modern clinical decision making explicitly acknowledges the evidence that contributes to each patient management decision, the strength of that evidence, the benefits and risks of alternative management strategies, and the role of patients’ or parents’ values and preferences in trading off those benefits and risks.
As my fellow clinicians in child health do, I encounter practices that are weak in evidence in every working day. Only fairly recently the important gap in the evidence that should underpin clinical choices for safe and effective treatments for children has come to the larger public’s attention. It has motivated the emergence of dedicated children’s research networks worldwide, like the National Institute for Health Research (NIHR) Medicines for Children Research Network in England, and the NICHD funded Pediatric Trial Network (PTN) in the USA.
So we can do more studies to evaluate the safety and efficacy of interventions that we prescribe to our patients. The evidence shows that, until recently, there have been relatively few paediatric clinical trials and a considerable number had shortcomings. As a result, the quantity, quality and relevance of research data involving children are still substantially lower than for adults. The conditions exist despite having plenty of data demonstrating that inadequate testing of interventions in children can result in ineffective or harmful treatments being offered, or beneficial treatments being withheld.
Standards for Research (StaR) in Child Health was founded in 2009 to create avenues to improve the efficiency and impact of paediatric clinical trials. This website gives you information on the “why, who, what and how”. In short, StaR Child Health’s aim is to create opportunities to raise the standard of research in sick children through the development and implementation of methodological and practical guidance. That should lead to better evidence for therapies, better decisions at the bedside and at the system level, and, eventually, better health outcomes.
As we are aware of the many challenges surrounding the uptake and dissemination of StaR’s guidance, we are looking to take measures to enhance uptake and dissemination. To date, representatives of a variety of stakeholder groups, including clinicians, researchers, methodologists, industry partners, regulators, and (paediatric) journal editors have shown interest in this work, and in fact participate in various activities of StaR Child Health.
Things are changing. Awareness is rising. More people, including the children and their parents feel it is better to do high quality research than to put up with the status quo. In many places it is no longer ‘too difficult’ to conduct clinical research with children as research support for children’s studies is becoming available in many countries. We now have got the public support, processes, infrastructure, better methodologies and tools for best research. And so, when, in practice, one encounters clinical problems that should be researched, now is the time to use these resources, engage with the local or national child health research network and take part in improving children’s’ and families’ health. If StaR’s work is to contribute to this important agenda, we need you to become involved. Please let us know what you think of our work, and, if possible, get involved in shaping and delivering StaR’s future!