What are high-impact research areas in pediatric emergency medicine fellowship?

High-Impact Research Areas in Pediatric Emergency Medicine Fellowship

Fellows should prioritize research in respiratory illnesses/asthma, clinical prediction rules for high-stakes/low-likelihood diseases, medication error reduction, injury prevention, and urgency/acuity scaling, as these represent the highest-priority multicenter research topics identified through formal prioritization processes. 1

Top-Priority Research Domains

1. Respiratory Illnesses and Asthma

• This represents the single highest-priority research area for multicenter pediatric emergency medicine studies 1
• Quality improvement research in guideline-based asthma care has demonstrated measurable impact on emergency department outcomes 2
• Research opportunities include comparing therapeutic interventions, optimizing steroid delivery routes, and standardizing treatment protocols 2

2. Clinical Prediction Rules for High-Stakes/Low-Likelihood Diseases

• Development and validation of decision rules for conditions like traumatic brain injury represent critical research needs 1
• The PECARN head trauma prediction rule exemplifies high-impact research that identifies children at very low risk of clinically-important brain injuries 2
• These studies require large multicenter cohorts to achieve adequate statistical power for rare but serious outcomes 1

3. Medication Safety and Error Reduction

• Medication dosing errors in pediatric emergency care represent a major patient safety concern requiring research solutions 2
• High-impact research includes developing computerized physician order entry (CPOE) systems with pediatric dosing parameters and standardized medication formulations 2
• Studies examining length-based tape accuracy and discharge medication prescribing errors are particularly relevant 2

4. Injury Prevention and Trauma Care

• Research spanning the entire EMSC continuum from prevention through rehabilitation represents a critical need 2
• Evidence-based prehospital care protocols for pediatric trauma require further development and validation 2
• Disaster preparedness research for pediatric emergencies remains an important gap 2

5. Triage and Acuity Assessment

• Urgency and acuity scaling systems specific to pediatric populations require validation research 1
• Studies addressing emergency department crowding and its impact on pediatric outcomes are needed 2

Additional High-Yield Research Areas

Mental Health Emergencies

• Pediatric and adolescent mental health emergencies in the emergency medical services system represent an expanding research need 2
• Research addressing access to mental health professionals with pediatric expertise is critical 2

Pain and Anxiety Management

• Relief of pain and anxiety in pediatric emergency patients requires ongoing research to optimize protocols 2
• Conscious sedation research examining various medication combinations for procedures remains relevant 2

Special Populations

• Brief resolved unexplained events (formerly apparent life-threatening events) require continued research for risk stratification 2
• Children with special health care needs and their emergency care coordination need further study 2

Systems-Based Research

• Patient- and family-centered care implementation and outcomes research 2
• Telemedicine applications to address access and workforce shortages 2
• Pediatric readiness in general emergency departments requires ongoing quality improvement research 2

Research Network Opportunities

The Pediatric Emergency Care Applied Research Network (PECARN) provides the infrastructure for conducting high-impact multicenter studies that can answer long-standing clinical controversies through randomized controlled trials and large-scale observational studies. 2, 1

Key Considerations for Fellowship Research

• Prioritize research questions that address morbidity and mortality outcomes rather than surrogate endpoints 1
• Focus on conditions with high prevalence (fever, trauma, respiratory illness) or high stakes (cardiac arrest, status epilepticus) 3
• Consider practicality of conducting research within available multicenter networks 1
• Target research gaps where evidence-based guidelines are lacking or controversial 2