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Ongoing Projects

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PREFER

Parenteral veRsus Enteral Fluids for infants hospitalizEd with bRonchiolitis: the PREFER shared decision making study

Bronchiolitis is one of the most common and costly reasons for hospitalization in children. For hospitalized children who are unsafe to feed orally, there is variation in use of intravenous (IV or parenteral) or nasogastric (NG or enteral) fluids. While both are safe, little is known if parents are involved in shared decision making of selecting IV or NG fluids or informed of benefits and trade-offs is unknown. PIRN is conducting a national, prospective, pragmatic, observational study across 15 hospitals to generate knowledge on shared decision making with parents in choosing between IV and NG fluids and on the benefits and harms of these two treatment options for hospitalized children with bronchiolitis. Funding Source: CIHR Patient-Oriented Research: Early-Career Investigator Priority Announcement

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ROUTINE

Renal ultrasound after first febrile urinary tract infection in hospitalized children: reducing overdiagnosis and cascade effects (ROUTINE)

Urinary tract infection (UTI) is one of the most common and costly reasons for childhood hospitalization. Based on low quality evidence, renal ultrasound is universally performed after the first febrile UTI in children at Canadian hospitals, which may result in overdiagnosis of ‘genitourinary abnormalities’ and lead to a cascade of unnecessary healthcare interventions. PIRN is conducting a national, prospective, pragmatic, observational study across 16 hospitals to determine the utility of universal screening renal ultrasound in hospitalized children after first febrile UTI. Funding Sources: Physicians’ Services Incorporated (PSI) Foundation and Canadian Institutes of Health Research (CIHR) Project Grant Program

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Image by Zoshua Colah

CareBEST

​Low-value care, and variation in practice for children hospitalized with bronchiolitis – a multicentric prospective observational study

Most healthcare costs associated with bronchiolitis are those related to hospitalization, and these costs have been increasing. Supportive care is recommended by national guidelines for the treatment of bronchiolitis, and many commonly used diagnostics and treatments in bronchiolitis are considered low-value. This mult-centre prospective observational cohort study of children hospitalized with bronchiolitis will develop effective interventions to reduce low-value care, and ensure the right resources go to the right patient at the right time.

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REIaL-P

Race, Ethnicity, Indigenous identity and Language preference for Pediatric research in the hospital setting

This study aims to better understand health inequities related to race, ethnicity, Indigenous identity, and language preference (REIaL) among children receiving hospital and emergency department care in Canada. Working with youth and families, researchers will co-develop a REIaL data collection tool and governance framework for pediatric research. The study will examine how REIaL is associated with healthcare experiences and outcomes, including shared decision-making, healthcare utilization, and adverse events across seven Canadian pediatric hospitals. Findings will help inform health equity initiatives and support efforts to address disparities in pediatric healthcare.

Image by Elen Sher
Image by Samuel Ramos

LOE

Improving Hospital Care of Children and Fomilies with Limited English: A Qualitative Study

Hospitalized children of parents with limited English are twice as likely to experience harm due to medical care, are known to have worse health outcomes, including having increased risk of adverse events, longer hospital stays and greater likelihood to undergo unnecessary tests and investigations. This multicentre qualitative study conducted across 5 PIRN sites, including 2 pediatric and 3 community hospitals. This study focuses on understanding the lived experience of families and children who have been hospitalized on a general pediatric inpatient unit and have limited English Proficiency (LEP).

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PIRN PRIORITISATION WORK

A Data-driven Approach to Identify High Priority Research Topics for Pediatric Hospital Care 

Despite extensive research on conditions managed in children’s hospitals and subspeciality units, conditions managed on general pediatric units are more prevalent. There are also important health inequalities in hospital use based on characteristics (e.g. socioeconomic status). PIRN was launched to address this gap and improve outcomes for hospitalized children. This population-based cross-sectional study of Canadian children and youth with hospital encounters will use health administrative data from the Canadian Institute for Health Information (CIHI) and Institut de la statistique du Québec (ISQ) to identify conditions that are the most costly, prevalent, and with the largest health inequalities as priorities for future research in hospital pediatrics.

Image by Elen Sher
Image by Samuel Ramos

CanFLO

Understanding the use and outcomes of high flow nasal cannula among infants admitted to Canadian hospitals with bronchiolitis: a multi-centre, retrospective cohort study (CanFLO)

Bronchiolitis is the most common lower respiratory tract infection in children under two years of age. Despite its prevalence, there is significant variability in the management of bronchiolitis. Increasingly, respiratory support with high flow nasal cannula (HFNC)—higher flow rates of warm, humidified gas—has been used among patients with bronchiolitis. The potential to be used outside of the intensive care setting makes HFNC an attractive treatment option. PIRN is conducting a retrospective study across 10 hospitals to describe the clinical parameters guiding HFNC use and discontinuation. This study aims to understand the patient factors that are associated with HFNC treatment failure, allowing the identification of the patient population that is most likely to benefit from this treatment.

Image by Elen Sher

POPCORN

Pediatric Outcome Improvement through Coordination of Research Networks 

POPCORN unites pediatric health researchers from 16 research sites and existing national networks in pediatric research across Canada to enhance responsiveness to emerging COVID-19-related issues, including unintended consequences of preventive measures. The overall objective is to prepare Canadian child health researchers and their networks to respond rapidly and cohesively to current and future pandemic or public health issues of importance.

PIRN is a Canadian network developed  to generate evidence that improves care and outcomes for hospitalized children in general paediatric settings.

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LAND ACKNOWLEDGEMENT

We would like to acknowledge the land on which SickKids operates. For thousands of years it has been the traditional land of the Huron-Wendat and Petun First Nations, the Seneca, and most recently, the Mississaugas of the Credit River. Today, Toronto is home to Indigenous Peoples from across Turtle Island. SickKids is committed to working toward new relationships that include First Nations, Inuit, and Métis peoples, and is grateful for the opportunity to share this land in caring for children and their families.

Last Updated: February 2026 by the PIRN Team.

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