Developing an Adaptive Paediatric Intensive Care Unit Platform Trial with Key Stakeholders: a Qualitative Study

Overview

Journal BMJ Open

Specialty General Medicine

Date 2025 Jan 8

PMID 39773799

Authors

Tracy Karen Mitchell

Julie C Menzies

Padmanabhan Ramnarayan

Doug William Gould

Elizabeth Deja

Shelley Marsh

Jennifer Ainsworth

Jennifer Preston

Hannah Sedgwick

Carly Tibbins

Paul R Mouncey

Mark J Peters

Kerry Woolfall

Affiliations

Soon will be listed here.

Abstract

Objectives: Platform trials were used successfully in adult populations during the COVID-19 pandemic. By testing multiple treatments within a single trial, platform trials can help identify the most effective treatments (and any interactions between treatments) for patients more quickly and with less burden for patients and their families. The aim of this qualitative research was to inform the design of the first adaptive platform trial for paediatric intensive care in the UK with young people, parents/carers and paediatric intensive care unit (PICU) staff.

Design: Qualitative semistructured focus group study. Data were analysed using reflexive thematic analysis.

Participants: Young people, parents/carers, and PICU medical, nursing and research staff.

Setting: The UK.

Results: A total of 86 participants (18 young people; 15 parents/carers; 53 PICU staff) took part in 1 of 10 focus groups between May and September 2023. Participants viewed the proposed PICU platform trial and use of research without prior consent to be acceptable. Findings provide insight into how the PICU platform trial should be designed and operationalised, including having a broad and inclusive population eligible for inclusion onto the platform trial, with different inclusion and exclusion criteria for each domain; starting the trial with no more than three domains and prioritising the outcomes of and (all participants). Optimal governance structure and suggestions about how any challenges to the success of the full trial can be overcome are also presented.

Conclusions: Young people, parents/carers and PICU staff viewed the proposed PICU platform trial to be acceptable. These key stakeholders supported us with the design of an adaptive platform trial for PICU that has a rigorous methodology, yet can be operationalised in a family-centred way, to provide high-quality evidence that can support clinical decision-making and guide the treatment of critically ill children. Our findings have informed the PICU platform trial protocol.

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