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Providing Conceptual Clarity for Global Paediatric Research

Dr Lee Jan Hau on how a more inclusive definition of acute paediatric critical illness will help in research and improving care.


Studies on children with life-threatening conditions are hindered by the absence of a common definition for acute paediatric critical illness. Research on how to improve care in low- and middle-income countries has been stymied because conventional paediatric critical illness definitions are not always applicable in these settings.


To tackle this challenge, researchers and clinicians from 40 countries proposed a definition based on the patient’s status rather than on resources, such as specific department admission or intervention use. It will enable clinical researchers to study paediatric critical illness more universally, which would lead to improvements in patient outcomes globally.

Published in The Lancet Global Health in January 2024, the paper aims to provide a more patient-centred and inclusive definition for acute paediatric critical illness.

"Paediatric critical illness should be recognised beyond a specific clinical setting."

Dr Lee Jan Hau, Senior Consultant, Children’s Intensive Care Unit, KK Women’s and Children’s Hospital


While high-income countries might classify the severity of an illness based on technical or resource-based criteria, such as a patient’s admission to the Intensive Care Unit (ICU), such classifications cannot be applied in resource-limited healthcare settings, which might not have an ICU or other resources in their hospitals.

“The proposed framework is highly applicable to countries in Southeast Asia and the wider Asia – especially in low- to medium-resource settings,” said Dr Lee. “This is also applicable to high-resource settings like Singapore, because the framework increases the awareness that paediatric critical illness should be recognised beyond a specific clinical setting.”


Led by St. Jude Children’s Research Hospital, United States, and involving a global group of acute paediatric critical illness experts, the study’s findings can be used by health systems across the region to identify critically ill children in clinical work or research settings.

Moving forward, we need to test and validate this proposed definition in a variety of settings to investigate its robustness,” said Dr Lee on next steps for this study. “I am hopeful that this definition will help standardise the recruitment and study of critically ill patients across various clinical setups."

Read the full press release here.