European Academy of Paediatrics Research in Ambulatory Settings network

It consists of paediatric practitioners from practices in European and Mediterranean countries and research consultants from  Europe in collaboration with the EAP and AAP PROS.

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About EAPRASnet

EAPRASnet (European Academy of Paediatrics Research in Ambulatory Settings network) is a practice-based research network that  was established in 2009. It consists of paediatric practitioners from practices in European and Mediterranean countries and research consultants from  Europe in collaboration with the EAP and AAP PROS.

What is the mission of  EAPRASnet?

The mission of EAPRASnet is to improve the health of European children and enhance the quality of  primary care paediatrics  by conducting  collaborative practice-based research.

What are EAPRASnet objectives?

Establishment of a structure and process to study the care provided to children in community-based general paediatric primary care settings and the effectiveness of that care; provision of investigative experience to a large group of practitioners on the study of care and treatment issues in practice;  dissemination of study results to paediatricians and other primary care practitioners, public health groups and groups formulating guidelines, standards and recommendations so that they might act on this new information.

What will EAPRASnet do?

EAPRASnet practitioners and researchers work together to generate research questions, design study materials and protocols, obtain research funding, collect study data, analyze collected data, and publish results. This collaboration is accomplished through EAPRASnet participants, , recruited and maintained by EAPRASnet national coordinators.

What kinds of studies will EAPRASnet be doing?

The network is the research laboratory of the primary care setting and in the latest study, EAPRASnet has enrolled up to 2014 a total of 1.600 active pediatricians from 43 countries .

A recruitment survey showed that areas of most interest for research were: quality of care indicators, communication with parents, obesity, attention deficit hyperactivity disorder and effective well child care. Main incentives for participation in a research project were interest in the topic (81%) and effort to improve quality of care (71%). Lack of time was the leading reported obstacle (72%).

A second electronic survey assessing primary care pediatricians’ estimations and practices regarding parents’ vaccination refusal was sent to 395 EAPRASnet members, with a response rate of 87 %. Of respondents who vaccinate in their clinic, 93% estimated the total vaccine refusal rate less than1%. Sixty nine percent of all respondents prefer a shared decision making approach to handle parents’ vaccine hesitancy.

In 2012 a survey on Use of Antibiotics in Upper Respiratory Tract Infections has been performed to evaluate European primary care paediatricians’ knowledge, attitudes and practice regarding antibiotic prescribing for upper respiratory infections in order also to identify targets for future intervention studies.

In 2013 a survey on “Paediatrician’s practices and perspectives concerning Urinary Tract Infections (UTIs) in children 1 month to 36 months” has been performed in 6 different languages with a significant contribution by 1.140 paediatricians from 26 European countries.

A short survey on Antibiotic Treatment for Childhood Pneumonia (EMPARI) has been completed by 740 paediatricians and the results have been published.

More recently a survey on Electronic Health Research Records (EHRs) in ambulatory settings has been completed by 670 paediatricians from 26 European Countries. The results, showing that there is marked heterogeneity in the use and functionalities of EHRs used among child primary child healthcare providers in Europe. have also been published in 2016.

The results of the EAPRASnet survey to examine European paediatricians’ knowledge on migrant children’s health problems, needs, inequalities, and barriers to access health care have been accepted for publication in 2017 .  Widespread lack of guidelines and specific providers’ training should be addressed to optimize health care delivery to migrant children.

A survey on Oral health training, knowledge, attitudes and practices of primary care paediatricians was published in 2018. It demonstrated that Paediatricians are familiar with some aspects of the oral health but are not confident in identifying the risk factors. The current postgraduate curriculum in Paediatrics should incorporate training on basic oral healthcare. In addition, continuous educational programs are needed to keep the knowledge of the paediatrician up to date.

In 2018 EAPRASnet had entered a new phase of its short history. A new survey for parents on Vaccination Confidence was launched in the offices of primary care pediatricians and practitioners of 18 European countries to assess parental behavior regarding immunization of their children, and to examine factors that potentially influence their immunization decisions. The study concluded that most parents in Europe believe in the importance of childhood vaccination. However, significant lack of confidence was found in certain European countries, highlighting the need for continuous monitoring, awareness and response plans. The possible influence of different types of healthcare providers on parental decisions demonstrated for the first time in the survey, calls for further research. Monitoring and continuous medical education efforts aimed mostly at those professionals who might not be likely to recommend vaccination are suggested. The study was published in 2019.

Hopefully, the new knowledge generated from the EAPRASnet studies could lead to changes in clinical guidelines or policy statements of paediatric pace-setting organizations, as has already happened with the AAP PROS studies influencing AAP policy.


Choosing Wisely Survey in Collaboration with the Japanese Pediatric Society

Is medical overactivity a problem in your country? Choosing Wisely and EAPRASnet recently conducted a survey in collaboration with the Japanese Pediatric Society  to identify the most common topics of over-investigation and overtreatment throughout Europe and Japan. 

Total records : 3353

Survey inserted in English website : 2718

Survey inserted in Japanese website : 635




Point of Care Tests Study

The use of point-of-care tests for managing acute childhood infections in Europe
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.

The survey is part of an EU funded research project called PERFORM which aims to develop diagnostic tests to differentiate between viral and bacterial infections in children. The survey will be conducted in countries where PERFORM and EAPRAsnet have strong local collaborators. 

More information can be found on PERFORM’s official website.

The survey was recently finished. Preliminary results were presented in Winter meeting December 2019. The next steps include cleaning the data, performing the statistical analysis and writing the manuscript.

EAPRASnet concludes vaccination survey, manuscript published in November 2019

The recently finished European vaccine confidence study has been the most challenging research ever run by EAPRASnet. Carried out over a period of three months, the survey collected close to 6000 completed responses. The team had processed all the gathered data and worked on the final publication document. The EAPRASnet survey on Parental Attitudes on Vaccine Confidence was designed as a multi-national study involving 18 European countries. The survey design was demanding in its methodology, requiring active participation of all national coordinators in applying for ethic committee approvals and in recruiting significant numbers of pediatricians in their countries. The latter had the responsibility to recruit parents to fill in the web- based survey translated to all languages. EAPRASnet would like to deeply thank the national coordinators, the pediatricians and the parents that helped collect this unique and unprecedented amount of European data. A special mention must be made Dr. Diego van Esso for his fantastic performance as the study’s Research Coordinator.

The main conclusions are:

  • An overall positive parent perception towards vaccines across the 18 countries surveyed (highest country – Portugal; lowest country – Bulgaria);
  • A link between decrease in vaccine confidence and receiving negative information on vaccines;
  • Parents have more confidence in paediatricians than homeopathists and general practitioners.


spring meetings

Minutes – Vilnius 2019

17 May 2019

Minutes – Sofia 2018

18 May 2018

Minutes – Dublin 2016

3 June 2016

Minutes – Bratislava 2015

29 May 2015

winter meetings

Minutes – Brussels 2022

2 December 2022

Minutes – Brussels 2019

6 December 2019

Minutes – Brussels 2018

8 December 2018

Minutes – Brussels 2017

2 December 2017

Minutes – Brussels 2016

December 2016

Minutes – Brussels 2016

29 January 2016

Minutes – Brussels 2014

5 December 2014

Minutes – Brussels 2013

December 2013


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

9. Vaccine confidence among parents: Large scale study in eighteen European countries. Hadjipanayis A, van Esso D, Del Torso S, Dornbusch HJ, Michailidou K, Minicuci N, Pancheva R, Mujkic A, Geitmann K, Syridou G, Altorjai P, Pasinato A, Valiulis A, Soler P, Cirstea O, Illy K, Mollema L, Mazur A, Neves A, Zavrsnik J, Lapii F, Efstathiou E, Kamphuis M, Grossman Z. Vaccine. 2019 Dec 14. pii: S0264-410X(19)31622-6. doi: 10.1016/j.vaccine.2019.11.068

10. COVID-19 Era Effect on Pandemic and Post-pandemic Pediatric Telemedicine Use: A Survey of the European Academy of Pediatrics Research in Ambulatory Settings Network. Reingold SM, Hadjipanayis A, van Esso D, del Torso S, Dornbusch HJ, de Guchtenaere A, Pancheva R, Mujkic A, Syridou G, Valiulis A, Mazur A, Rios J, Spreitzer MV, Mamenko M, D’Avino A, Kubatova G, Geitmann K, Wyder C, Altorjai P, Michailidou K and Grossman Z (2021). Front. Pediatr. 9:713930. doi: 10.3389/fped.2021.713930 https://doi.org/10.3389/fped.2021.713930

11. Availability and use of rapid diagnostic tests for the management of acute childhood infections in Europe: a cross-sectional survey of paediatricians.
Juan Emmanuel Dewez , Lucy Pembrey , Ruud G Nijman , Stefano Del Torso , Zachi Grossman , Adamos Hadjipanayis , Diego Van Esso, Emma Lim , Marieke Emonts , James Burns , Christèle Gras-LeGuen , Daniela Kohlfuerst , Hans Jürgen Dornbusch , Karen Brengel-Pesce , Francois Mallet , Ulrich von Both , Maria Tsolia , Irini Eleftheriou , Dace Zavadska , Ronald de Groot , Michiel van der Flier, Henriëtte Moll , Nienke Hagedoorn , Dorine Borensztajn , Rianne Oostenbrink , Taco Kuijpers , Marko Pokorn , Katarina Vincek , Federico Martinón-Torres , Irene Rivero , Philipp Agyeman , Enitan D Carrol , Stéphane Paulus , Aubrey Cunnington , Jethro Herberg , Michael Levin , Aida Mujkić , Karin Geitmann , Liviana Da Dalt , Arūnas Valiulis , Risto Lapatto , Garyfallia Syridou , Péter Altorjai , Paul Torpiano , Ketil Størdal , Károly Illy , Artur Mazur , Mateja Vintar Spreitzer , Joana Rios , Corinne Wyder , Ivanna Romankevych, Romain Basmaci , Salvador Ibanez-Mico , Shunmay Yeung
PLoS One 2022 Dec 20;17(12):e0275336. doi: 10.1371/journal.pone.0275336.


Contact email for EAPRASnet:


 EAPRASnet Advisory Committee


Stefano del Torso, Italy / Zachi Grossman, Israel/ Adamos Hadjipanayis, Cyprus / Diego Van Esso, Spain.

ECPCP Delegate: Christine Magendie, France

yEAP Delegate: Nora Karara, Germany


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