So, a little over five years ago, this panel was formed with SCCM support. Jerry Zimmerman was instrumental in enlisting SCCM in this effort, and they were extremely helpful and made this happen, frankly. This seems like a long time, over five years, although in 2019, when we had our kickoff meeting, it became apparent that there were no datasets that were actually adequate or remotely comparable to the data used in Sepsis-3 to develop new criteria in children. And then, of course, in 2020, the world changed a bit, but despite that, we forged ahead with a systematic review and international survey, which we'll talk more about. Drs. Bennett and Sanchez-Pinto successfully competed for funding to assemble a massive database made up of EHR records from sites in the U.S. and across the world, and began to get data access. We published some additional manuscripts in 2022, and then over the past year, analyses have been conducted in earnest, and then over the summer, we launched the Delphi process and came to consensus in late summer, early fall. So this is just a picture of before we kind of knew what we were in for back in 2019, in Salzburg. Here are the members of the task force with their country of residence and their expertise. One thing to note here is that the Society of Critical Care Medicine, of course, is a critical care society, but they were visionary enough to know that that is not adequate for a condition such as sepsis, which involves so many other subspecialties. So this task force was intentionally diverse in terms of medical expertise and in terms of geography. So we had members from 12 countries across six continents. We had several guiding questions. We started off with what can we learn from sepsis 3, both the process and the subsequent debate after those results were released. We wanted to get a sense of what the needs of clinicians caring for children around the world were around sepsis definitions and criteria. We want to maximize generalizability for diverse health care settings, both within the hospital and in differently resourced environments. And then we wanted to capture sepsis as a disease or syndrome in a way that would enable screening for patients at risk of developing sepsis. And then finally, we were trying hard to thread the needle in terms of being pragmatic and characterizing this complex heterogeneous condition without being overly simplistic. With that, we conducted a systematic review to obtain current evidence for the criteria, conducted a global survey, and Drs. Bennett and Sanchez-Pinto established their computational team for data analytics. And this all fed into really all of the work of the task force that ultimately led to the Delphi process to finalize the criteria, which were then externally validated within the data assembled by the data team. We had five publications up to today, starting back in 2020. As of today, we have two more with development and validation of the criteria, a really deep dive into the innovative methods used to develop them, and then the criteria themselves, which are published in JAMA today, and there will be some QR codes later to make it easy for folks to access those. So we're excited about this session. We have a host of great speakers to go through the different topics. Halden Scott is going to be talking about the systematic review, Mark Hall, results of the survey, Nelson, Sanchez-Pinto, and Tal Bennett about development of the criteria. Mark Peters and Matt Wiens will discuss some of the controversies, some of the many controversies that we encountered as we tried to develop these criteria with a diverse group. And then Ennaton will be, Ennaton Carroll will be talking about operationalizing the definition, really how to use the definitions in your local environment. We're going to conclude first with a roundtable of the speakers. We'll ask some questions of them and then open up the microphones on the floor for questions from the audience. So we're excited about this session, and we're going to move on to Halden Scott, who's going to present criteria for pediatric sepsis, a historic perspective provided by systematic review.

pediatric sepsis criteria

SCCM

Delphi process

EHR database

JAMA publication