Paediatric practice needs better evidence—gained in collaboration with parents and children

All those concerned with the clinical care of children have a responsibility to improve that care, and one way of achieving this is by research. The importance of research into normal childhood development and into the methods of promoting good health, together with studies of the aetiology, natural history, diagnosis, and treatment of childhood diseases is well recognised. So too are the perils of relying on information from studies conducted in adults and generalising these to children. However, undertaking clinical research in children presents unique challenges.1

The most obvious of these are the ethical ones: the need to protect children from harm while respecting their autonomy and to obtain properly informed consent from parents, and, when possible, the children themselves. There are also methodological challenges. Outcome measures, developed and validated in adults, are unlikely to be appropriate or feasible for children and babies. The proportions of children affected by chronic diseases are smaller and the diseases often more heterogeneous than in adults, and diagnostic …