{
  "abstract": "Introduction: Asthma is one of the most common chronic diseases of childhood and a leading cause of emergency department (ED) presentations worldwide. However, for those experiencing a severe exacerbation, there is a limited evidence base to decide which treatment works best. A major contributor to this, is the considerable heterogeneity in outcome selection which limits comparison between trials. The development of a core outcome set (COS) may improve this, enhancing the quality, comparability and applicability of future research. This protocol describes the development of the first internationally derived COS for trials evaluating interventions in severe, acute asthma exacerbations.\n\nMethods and analysis: A modified Delphi methodology will be used. An international steering committee comprising experts has been established through the Paediatric Emergency Research Network Asthma Working Group. For participants, this study will seek balanced representation across the six WHO regions and include clinicians who regularly manage children with severe acute asthma exacerbations and parents of children previously hospitalised with an asthma exacerbation. A target of 180 participants will be recruited, allowing for an anticipated 30% attrition rate between rounds and approximately 80 participants completing the final round. Three rounds of online surveys will be undertaken. Participants will rate the importance of outcomes identified through a systematic review and qualitative studies, with opportunities to suggest modifications and additional outcomes. Consensus after round 3 will be defined as either: (1) ≥70% of participants from both stakeholder groups scoring an outcome as critically important (7–9 on a 9-point Likert scale) and ≤15% scoring it as of limited importance (1–3) or (2) ≥90% of participants from either stakeholder group scoring the outcome as critically important.\n\nEthics and dissemination: Ethical approval was granted by the Southern Adelaide Health Human Research Ethics Committee (HREC reference number 2025/HRE00375). Findings will be disseminated through peer-reviewed publications, conference presentations and stakeholder engagement activities.\n\nThis study has been prospectively registered with the Core Outcome Measures in Effectiveness Trials (COMET), registration number 1016.",
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  "affiliations": [
    "Emergency Department, Flinders Medical Centre, Bedford Park, South Australia, Australia",
    "College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia",
    "Departments International Collaborative, PREDICT Paediatric Research in Emergency, Melbourne, Victoria, Australia",
    "Emergency Department, The Royal Children’s Hospital Melbourne, Melbourne, Victoria, Australia",
    "Murdoch Children’s Research Institute, Clinical Sciences, Parkville, Victoria, Australia",
    "Department of Paediatrics and Department of Critical Care, The University of Melbourne, Parkville, Victoria, Australia",
    "School of Medicine, Cardiff University, Cardiff, UK",
    "National Children’s Hospital, San Jose, Costa Rica",
    "University of Costa Rica, San Jose, Costa Rica",
    "Regional Collaborative Center, Institute of Child Health, Madras Medical College, Chennai, India",
    "Pediatric Resuscitation and Emergency Research Network (PRERNI), India, India",
    "Primary Children’s Hospital, Salt Lake City, Utah, USA",
    "Department of Pediatrics, The University of Utah School of Medicine, Salt Lake City, Utah, USA",
    "Pediatric Emergency Care Applied Research Network, Salt Lake City, Utah, USA",
    "Departments of Surgery and Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand",
    "Children’s Emergency Department, Starship Children’s Health, Auckland, New Zealand",
    "Department of Emergency Medicine, KK Women’s and Children’s Hospital, Singapore",
    "University of Utah School of Medicine, Salt Lake City, Utah, USA",
    "Division of Paediatric Emergency Medicine and Research Institute, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada",
    "University of Florida, Gainesville, Florida, USA",
    "Red Colaborativa Pediatrica de Latinoamercia, Montevideo, Uruguay",
    "Unidad de Cuidados Intensivos de Niños del Centro Hospitalario Pereira Rossell, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay",
    "Department of Paediatrics and Child Health, Kenyatta University, Nairobi, Kenya",
    "Mater Misericordiae Hospital, Nairobi, Kenya",
    "Centre Hospitalier Universitaire de Kigali, Kigali, Rwanda",
    "St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia",
    "Hanagal Shri Kumareshwar Hospital and Research Centre Hospital, Bagalkot, India",
    "Department of Paediatrics, Maulana Azad Medical College, New Delhi, India",
    "Asiri Hospital Galle Queensbury, Karagitiva, Sri Lanka",
    "Clinical Sciences Division (CSD), Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh",
    "Emergency Department, Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester, UK",
    "SAPPHIRE Group, Department of Health Sciences, University of Leicester, Leicester, UK",
    "Imperial College London, London, UK",
    "University Hospital of Wales, Cardiff, UK",
    "Sidra Medicine, Emergency Medicine, Doha, Qatar",
    "Emergency Department, Fakeeh University Hospital, Dubai, UAE",
    "Maroof Clinical Trial Unit, Research Department, Maroof International Hospital, Islamabad, Pakistan",
    "Emergency Department, HITEC-IMS, Taxila, Punjab, Pakistan",
    "Hospital Universitaria de mataro, Barcelona, Spain",
    "Department of Pediatrics, Northwest Clinics, Alkmaar & Den Helder, Netherlands"
  ],
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  "arxiv": null,
  "author_total": 32,
  "authors": [
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      ],
      "name": "Charmaine Gray",
      "orcid": "0000-0002-3625-6505"
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      "name": "Leah Armit"
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      "name": "Sebastián González"
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      "name": "Lilian Chebet Kimeto"
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      "name": "Tigist Bacha"
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      "name": "Raghavendra Vanaki"
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      "name": "Romit Saxena"
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      "name": "Damian Roland"
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      "name": "Dorine Borensztajn"
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  "bibtex": "https://research.draconitic.com/paper/97p226zb48w7v.bib",
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  "doi": "10.1136/bmjopen-2026-124611",
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  "pmcid": "PMC13723850",
  "pmid": "42957292",
  "published": "2026-10-29",
  "publisher": "BMJ",
  "ris": "https://research.draconitic.com/paper/97p226zb48w7v.ris",
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      "first_seen": "2026-10-30T12:19:44Z",
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  "subjects": [
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  "title": "Establishing a core outcome set for use in trials of severe acute paediatric asthma exacerbation (2–17 years): study protocol for an international co-design Delphi survey – a Paediatric Emergency Research Network study initiative",
  "title_text": "Establishing a core outcome set for use in trials of severe acute paediatric asthma exacerbation (2–17 years): study protocol for an international co-design Delphi survey – a Paediatric Emergency Research Network study initiative",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:35Z",
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