Summary of REPEM recent activities and future plans
Rianne Oostenbrink, Silvia Bressan
REPEM has been promoting, connecting and supporting PEM research over many years now. The COVID pandemic has been a catalyst for a broader and more solid European participation to COVID-related studies, which are at present dominating the scene within the network. These very important studies, the survey on ED preparedness and response published last year in Annals of Emergency Medicine, and the ongoing EPISODES and ReSync studies (please see separate updates on these projects) have proved the ability of REPEM to provide a flexible and inclusive framework to ensure broadened participation in these initiatives of many PED across Europe.
REPEM and all its participating centers have been incredibly busy since last year in contributing to these fantastic projects, focusing time and efforts to have ethical procedures and agreements in place, and to the extensive data collection. This has proven challenging for some centres, but a great learning opportunity for all. REPEM has supported the leading investigators in the design and conduct of these projects gaining precious insight into challenges, limitations and barriers that hamper clinical research based on electronic medical records across European PED.
Based on the groundwork provided by EPISODES and its related projects, REPEM is now looking into funding opportunities with the vision to develop, in the long term, a European database of pediatric ED visits, which could be sustainable over time and accurately collecting information that is truly comparable across sites. This will be an important goal to achieve in the years to come, as it opens the possibility to robust, generalizable studies on the epidemiology and burden of paediatric ED presentations, variation in care and patient outcomes, best management of low frequency high stakes paediatric emergency conditions, as well as implementation of evidence base care for common less serious conditions.
A shorter-term goal is to restore and update the REPEM website under the EUSEM website by the end of this year. The REPEM website has been unfortunately taken down. We wish to thank Ron Berant from Israel for his work on the website until it was up and running.
A quick update on REPEM participation in PERN studies: the PAINT study led by Itai Shavit, from Israel, completed data collection at the end of March including 3,160 patients, making it the largest existing database of children presenting to the ED for intussusception. Well done Itai and the PAINT investigators! Suzanne Schuh from Canada is finalizing the protocol of a study examining specific aspects of practice variation in pediatric acute asthma. More information about opportunity for participation of REPEM centres will be posted through the REPEM email list.
EUSEM supported EPISODES study symposium
To celebrate the successful EPISODES study collaboration, a symposium on child health and the impact of the COVID-19 pandemic was hosted on February 16th 2021. A wide range of topics were discussed by several international expert speakers, expertly chaired by membes of the EPISODES study steering committee. There was an important and inspiring presentation providing the children’s perspectives of the pandemic by Dr. Emma Lim (UK). The ever impressive Dr. Damian Roland (UK) and Dr. Alasdair Munro (UK) had a debate about the how COVID-19 pandemic, and the resulting social distancing measures, affected children adversely. We had expert discussions by Dr. Pieter Fraaij (NL) and Dr. Naim Ouldali (FR) providing the latest evidence on SARS-CoV-2 and the treatment of PIMS-TS. Dr. Ulrich von Both (GER) and Dr. Danilo Buonsenso (IT) spoke about the importance of including refugee children and young people, as well as lower and middle income countries in the global fight against COVID-19. Lastly, Prof. Henriette Moll (NL) shared her extensive eperiences on how to conduct multinational research in paediatric emergency medicine, with a focus on observational studies improving diagnostic strategies in children with fever. During the symposium we also presented the preliminary findings of the EPISODES study (Dr. Silvia Bressan (IT), Dr. Katy Rose (UK), D. Ruud Nijman (UK)). All presentations are still highly relevant, with, despite increasing vaccination rates in many European countries, the COVID-19 pandemic ongoing; they are freely accessible via the EUSEM online academy (https://academy.eusem.org/eusem/#!*menu=6*browseby=8*sortby=2*media=1*ce_id=1983)
EPISODES and ReSync study
Inspired by the enormous reduction in the number of children attending the emergency department during the first wave of the COVID-19 pandemic, the EPISODES study was set up last year supported by EUSEM. By now, 42 institutions from 19 countries have joined the EPISODES study and its sub-study: the ReSync study. The EPISODES study will look at the outcomes, severity and patterns of presentations of children visiting emergency departments across Europe, and the impact that COVID-19 has had on acute illness in children. The ReSync sub-study will focus more closely on children with bronchiolitis. Preliminary findings of the EPISODES study have been presented at the European Society of Paediatric Infectious Diseases and the Royal College for Paediatrics and Child Health (UK). A manuscript on how each of the EPISODES study sites changed their local health care systems in response to the first wave of the COVID-19 pandemic is currently under review (first author: Dr. Katy Rose, UK). Our Swedish colleagues, with Dr. Samuel Rhedin as first author, published their experiences in Acta Paediatrica , acknowledging the EPISODES study group.
REPEM Research session: European society for Paediatric Infectious Diseases
During the last ESPID conference (26-05-2021, Geneva) Silvia Bressan (IT), Rianne Oostenbrink (NL), Henriette Moll (NL), and Ruud Nijman (UK) organised a 90 minutes virtual research session on behalf of the Research in European Paediatric Emergency Medicine (REPEM) network. The REPEM is the formal section of the European Society of Emergency Medicine responsible for research in paediatric emergency medicine; and all EUSEP members are strongly encouraged to sign up for the REPEM research newsletter and activities. The ESPID research session was a unique opportunity to discuss ways of improving research in paediatric emergency medicine and infectious diseases. More than 150 delegates attended the research session, with many dedicated to taking level of academic paediatric emergency medicine to the next step.
This year, from SIG Education, together with REPEM, our Research Network, we have started a collaboration with the journal of our Society, the European Journal of Emergency Medicine. This initiative will consist of the publication of a series of brief papers that will review the main novelties in pediatric emergency medicine. These documents are intended to spread the knowledge of our specialty, as well as being an opportunity for young researchers to make their first publications. We hope to submit four papers per year, and the first of them, by Danielle McCollum, about mental health in the pediatric emergency department, can now be read as published ahead-of-print form.
The response of the members of our society has been fantastic, and today there are already papers scheduled until 2023, which demonstrates the scientific health of EuSEP.
After last year's virtual experience our 2021 annual congress was presential. We celebrated it, with a really interesting pediatric track, with very diverse topics, treated by the best experts in the field, both from Europe and from the US and Australia. In addition, to the already classic and always in demand APEC course, directed by Said Idrissi, this year two other pre-congress courses were added: a course on analgesia and sedation, which was directed by Itay Shavit, and a POCUS course, directed by Niccolò Parri. With all these directors, the quality of the courses is more than guaranteed.
Check out the newsletters that have been published this year: