The European Academy of Paediatrics Research in Ambulatory Settings network (EAPRASnet) was launched in 2008 to conduct research using primary care data from European countries. The network involves primary care pediatricians who collect patient data through surveys and electronic health records. EAPRASnet aims to study topics like quality of care, child health inequalities, vaccination attitudes and antibiotic use across Europe. It has published several studies on issues like managing urinary tract infections, pneumonia treatment preferences, and use of electronic health records. Current projects examine health issues for migrant children and oral health practices among European pediatricians.

1. European Academy of Paediatrics
Research in Ambulatory Settings Network
European Academy of Paediatrics Research in Ambulatory Settings network
(EAPRASnet)
The European Academy of Paediatrics (EAP) is composed of delegates from European national and
specialist pediatric societies as well as from national paediatric primary care professional
organizations. It is also the UEMS pediatric section and as such, represents the official political
voice for both children and paediatricians throughout Europe.
The aim of EAP is to promote the health of children as well as to alleviate suffering from diseases
in infancy, childhood and adolescence up to the completion of growth and development both within
and outside of Europe. The above mentioned objectives will be achieved by harmonizing,
coordinating and setting standards for paediatric training, paediatric care and paediatric research
throughout Europe.
In 2008, the European Academy of Paediatrics launched a paediatric-based research network –
EAPRASnet (European Academy of Paediatrics Research in Ambulatory Setting network). The
network has recruited primary care and general paediatricians from European and Mediterranean
countries. The aim was to collect data originating from the primay paediatric care settings in
Europe, by which data harmonization and optimization of the care given to children shall be
achieved.
Since 2008, the network was involved in several research projects. These were attitudes and
practice paediatricians' surveys regarding the following subjects: preferred future research topics,
vaccination refusal and antibiotic therapy for upper respiratory infections1,2,3
. The fourth survey
regarding UTI management had more than 1200 paediatricians responding and has been recently
published4
.
Quality of care indicators was rated first among the preferred research topics in the first survey1
.
This finding highlights the potential of EAPRASnet , the only research arm of EAP and as such can
contribute to the buildup of data on primary paediatric health services across Europe and their
impact on health outcomes.
Comparing health services across Europe, focusing on the prevention of poor health, is one of the
main research needs. In addition to health surveillance, it is essential to analyze the many sources of
data available in order to make European children more visible. EAPRASnet can be an important
tool in identifying and measuring the problems of childrens' lives and health in Europe, thus
facilitating the planning of the necessary social strategy based on sound scientific knowledge .
The data can be generated through two optional study designs. The first is an observational design
in which paediatricians document relevant visit information by web based tools according to the
formulated research question. These data can apply to clinical presentation, diagnostic workup,
therapeutic options as well as being used as a tool to gather relevant information on the health of
children according to the information needed in particular aiming at robust and effective inter-
country comparative primary research .
Defined outcomes may be then be evaluated using the same method. In addition the second option
is using the electronic databases containing all the data pediatricians document in their electronic
health records (EHRs). Most paediatricians in Europe use EHRs, and the cumulative information of
this tool has a huge information potential.
Both these designs can be used as research tools, using each of them appropriately and in
accordance with the need for new information taking in consideration currently unresearched areas
and also future health trends in order to be able to influence the public political will.
The aim of the most recent survey “Child Health Inequalities among Migrant Children in the
European Region” has been to analyse child health inequalities among migrant children in the

2. European Academy of Paediatrics
Research in Ambulatory Settings Network
European Region. In the last several years there has been a strong migratory flow to many European
countries and many of us have gained experience dealing with the health problems of the migrant
children which we could share replying to this survey.
This study has been planned in collaboration with the EAP Advocacy working group, chaired by
Angel Carrasco and it has been submitted for publication.
Another study has been completed on Oral Health to evaluate primary care paediatricians’ training,
knowledge, attitudes and practices regarding OH in Europe in collaboration with the European
Association of Pediatric Dentistry. The final paper will be submitted for publication.
EAPRASnet EC has completed a study to assess parental attitudes to vaccination in Europe, and to
examine factors that potentially influence their immunization decisions regarding their children,
which has been launched in 2018 in 18 European Countries collecting over 6000 replies.
At present EAPRASnet had been approached by a group based at Imperial College (London) and in
Newcastle to collaborate on a new survey which aims to describe the availability and use of point-
of-care tests for the management of febrile children in the wide range of settings in Europe where
such children are assessed, including primary care, and hospital outpatient and emergency
departments.
Steering Committee
Chairman : Stefano del Torso, Italy
Scientific Director : Zachi Grossman, Israel.
Scientific Advisor : Adamos Hadijpanayis, Cyprus
Research Coordinator : Diego Van Esso , Spain;
EAP Primary Secondary Working Group Delegates:
Jerney Zavrsnik, Slovenia ; Karoli Illy, The Netherland
With the collaboration of
Richard Wasserman Pediatric Research in Office Settings -AAP, USA

3. European Academy of Paediatrics
Research in Ambulatory Settings Network
PUBLICATIONS
1. delTorso S, vanEsso D, Gerber A, Drabik A, Hadjipanais A, Nicholson A,
Grossman Z. European Academy of Paediatrics Research in Ambulatory Setting
Network (EAPRASnet): A multi-national general paediatric research network for
better child health. Child Care Health Dev 2010;36:385-91.
2. Grossman Z, van Esso D, delTorso S, Hadjipanayis A, Drabik A, Gerber A,
Miron D. Primary care pediatricians’ perceptions of vaccine refusal in Europe.
Pediatr Infec Dis J 2011;30:255-56
3. Grossman Z, Del Torso S, Hadjipanayis A, van Esso D, Drabik A, Sharland
M. Antibiotic prescribing for upper respiratory infections: European primary
paediatricians' knowledge attitudes and practice. Acta Paediatr. 2012;101:935-40
4. Adamos Hadjipanayis, Zachi Grossman, Stefano del Torso, Diego van
Esso,Hans Juergen Dornbusch, Artur Mazur, Anna Drabik, Giovanni Montini
Current primary care management of children aged1–36 months with urinary tract
infections in Europe:large scale survey of paediatric practice
Arch Dis Child 2014;0:1–7. doi:10.1136/archdischild-2014-306119
5. Julia A. Bielicki, Charlotte I.S. Barker, Alike W. van der Velden, Mike Sharland,
Diego van Esso,Adamos Hadjipanayis, Stefano del Torso and Zachi Grossman
Antibiotic preferences for childhood pneumonia vary by physician type and
European region
ERJ Open Res 2016; 2: 00001-2016 | DOI: 10.1183/23120541.00001-2016
6. Primary care paediatricians' use of electronic health records in Europe
Zachi Grossman, Stefano del Torso, Diego van Esso, Jochen Ehrich, Peter Altorjai,
Artur Mazur, Corinne Wyder, Ana Margarida Neves, Hans Jurgen Dornbusch, Elke
Jaeger Roman, Antonella Santucci, Adamos Hadjipanayis
Child Care Health Dev 2016 doi:10.1111/cch.12374
7. Migrant children’s health problems, care needs, and inequalities:European primary
care paediatricians’ perspective
A. Carrasco‐Sanz I. Leiva‐Gea, L. Martin‐Alvarez, S. del Torso, D. van Esso, A.
Hadjipanayis, A. Kadir, J. Ruiz‐Canela, O. Perez‐Gonzalez, Z. Grossman
Child Care Health Dev. 2017;1–5. DOI: 10.1111/cch.12538
8. Oral health training, knowledge, attitudes and practices of primary care
paediatricians: a European survey
Adamos Hadjipanayis, Zachi Grossman, Stefano del Torso, Kyriaki Michailidou,
Diego Van Esso, Rita Cauwels,
European Journal of Pediatrics https://doi.org/10.1007/s00431-018-3108-z