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Protocol
ESPGHAN and NASPGHAN 2023 protocol for paediatric FAPD treatment guidelines (standard operating procedure)
  1. Morris Gordon1,
  2. Marc A Benninga2,
  3. Rachel Borlack3,
  4. Osvaldo Borrelli4,
  5. Ashish Chogle5,
  6. Anil Darbari6,
  7. Jernej Dolinsek7,
  8. Jip Groen8,
  9. Julie Khlevner9,
  10. Carlo Di Lorenzo10,
  11. Hannibal Person11,
  12. Miguel Saps12,
  13. Vassiliki Sinopoulou1,
  14. Julie Snyder13,
  15. Merit Tabbers14,
  16. Nikhil Thapar15,
  17. Arine Vlieger16
  1. 1University of Central Lancashire, Preston, UK
  2. 2Emma Children's Hospital UMC, Amsterdam, The Netherlands
  3. 3Children's Hospital at Montefiore, New York, New York, USA
  4. 4Great Ormond Street Hospital for Children, London, UK
  5. 5Children's Hospital of Orange County, Orange, California, USA
  6. 6Children's National, Washington, District of Columbia, USA
  7. 7University Medical Centre Maribor, Maribor, Slovenia
  8. 8VU University Medical Centre Amsterdam, Amsterdam, The Netherlands
  9. 9Division of Pediatric Gastroenterology, Hepatology and Nutrition, New York Presbyterian Morgan Stanley Children's Hospital, New York, New York, USA
  10. 10Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, USA
  11. 11Seattle Children's Hospital, Seattle, Washington, USA
  12. 12University of Miami Miller School of Medicine, Miami, Florida, USA
  13. 13Harvard Medical School, Boston, Massachusetts, USA
  14. 14Amsterdam University Medical Centres, Duivendrecht, The Netherlands
  15. 15Queensland Children's Hospital, South Brisbane, Queensland, Australia
  16. 16Department of Paediatrics, St Antonius Hospital, Nieuwegein, The Netherlands
  1. Correspondence to Professor Morris Gordon; Mgordon{at}uclan.ac.uk

Abstract

Introduction To date, no international guidelines have been published for the treatment of paediatric functional abdominal pain disorders (FAPDs), subcategorised into functional abdominal pain–not otherwise specified (FAP-NOS), irritable bowel syndrome (IBS), functional dyspepsia and abdominal migraine (AM). We aim for a treatment guideline, focusing on FAP-NOS, IBS and AM, that appreciates the extensive array of available therapies in this field. We present the prospective operating procedure and technical summary protocol in this manuscript.

Methods Grading of Recommendations, Assessment, Development and Evaluation (GRADE) will be followed in the development of the guideline, following the approach as laid out in the GRADE handbook, supported by the WHO. The Guideline Development Group (GDG) is formed by paediatric gastroenterologists from both the European Society for Pediatric Gastroenterology, Hepatology and Nutrition, as well as the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Also, one clinical psychologist with expertise in FAPDs is a voting member in the GDG. A final consensus list of treatment options is translated into ‘patient, intervention, comparison, outcome’ format options. Prospective agreement on the magnitude of health benefits or harms categories was reached through a Delphi process among the GDG to support grading of the literature.

There will be a detailed technical evidence review with randomised controlled trial data that will be judged for risk of bias with the Cochrane tool. Recommendations are preferably based on GRADE but could also be best practice statements following the available evidence. A full Delphi process will be used to make recommendations using online response systems. This set of procedures has been approved by all members of the GDG.

  • Gastroenterology
  • Psychology
  • Health services research

Data availability statement

No data are available.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjpo-2023-002166

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    Data availability statement

    No data are available.

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    Footnotes

    • Twitter @drmorrisgordon

    • Contributors Delegates of NASPGHAN (AC, MS, AD, JK, CDL) conceived the idea for this international treatment guideline. Evidence synthesis guidance was sought through Cochrane Gut (MG, VS). MG designed the protocol in initial draft form to support the approval of the guideline process. An invitation was extended to ESPGHAN to join the Guideline Development Group led by MAB and MT. Both paediatric societies have invested in the development of this guideline. An original draft for this protocol manuscript was made by MG with JG, and then finalised by the Cochrane team (MG, VS) and the core research team from ESPGHAN (MAB, MT). For the guideline development, the core research team from ESPGHAN (MAB, JG, MT) will provide overall direction and planning. The Cochrane team (MG, VS) will verify the analytical methods and support the overall execution. Coauthors MAB, RB, OB, AC, AD, JD, JK, CDL, HP, MS, JS, MT, NT and AV agreed on the review questions, approved the protocol and contributed to the final version of this manuscript.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. A small fee was made available through the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) for travel expenses to facilitate physical meetings. The European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) covered travel expenses to facilitate the face-to-face summit for its delegates.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.