Identifying research priorities for Paediatric Surgery in Australia and New Zealand.

Paediatric surgeons manage a spectrum of conditions, from the neonatal period up to 16-18 years of age; however much of the scientific evidence for relevant treatment pathways is of low quality. For many conditions, treatment varies from centre to centre and even from surgeon to surgeon, often based on expert opinion; children with the same condition might have surgery in one unit but watchful waiting in another. Underlying this variation are differences in opinion, and insufficient high-level evidence with few prospective randomized studies. Such studies may be challenging to design, fund and recruit into, and are more likely to succeed if there is a collaborative approach. As a result, much of the paediatric surgical literature is populated with case studies or retrospective case-series rather than quality randomised controlled trials. For laboratory-based research, the increased regulation and small case numbers has limited the availability of normal and disease-specific tissue specimens from children, meaning that researchers are often reliant on animal models with questionable applicability to human disease. In Australia and New Zealand specific challenges for research in Paediatric Surgery include: - Collaboration: Bringing together paediatric surgeons, researchers, and policymakers through collaborative research for large-scale studies is often difficult due to geographical distances and variations in local health policies. - Funding limitations: securing adequate funding for child-focused research can be difficult, especially for long-term studies. Raising awareness about the need for child-focused research among government bodies, industries, and philanthropic organisations might help secure better funding. - Data Collection: Gathering reliable data from children requires age-appropriate methods and tools, which can be complex and resource-intensive. Developing creative ways to design prospective randomized studies, including age-appropriate tools and inclusive protocols, could help overcome recruitment and data collection barriers. - Policy Impact: Translating research findings into actionable policies that benefit children and families is often a slow and challenging process. This study includes two parts: - Literature review aiming at identifying current areas of research for Paediatric Surgery in ANZ - Scoping survey of the Australian and New Zealand (ANZAPS) members to ascertain consensus on what paediatric surgeons, working in ANZ, consider to be areas of priority for research We hope that this study will form the basis for collaborative research to standardise the diagnosis and management of paediatric surgical conditions.