# Mini-Review: From measurement to prediction—a conceptual paradigm shift in assessing overcrowding in pediatric emergency departments since 2021

## TL;DR

This paper reviews recent advances in predicting and measuring overcrowding in pediatric emergency departments, highlighting a shift from past-focused to future-focused methods.

## Contribution

The paper introduces a conceptual shift toward predictive models for overcrowding in pediatric emergency departments, emphasizing pediatric-specific validation.

## Key findings

- New predictive models can anticipate PED overcrowding before it occurs.
- Unidimensional and multidimensional metrics are being replaced by temporally oriented approaches.
- Pediatric-specific validation and multicenter evaluation are critical for reliable overcrowding assessment.

## Abstract

Overcrowding in pediatric emergency departments (PEDs) is an increasing global challenge. While adult emergency medicine has developed several validated measures to assess overcrowding, pediatric-specific methods remain scarce. In recent years, new approaches have emerged, including the first predictive models capable of anticipating crowding before it occurs. This Mini-Review provides a narrative synthesis of recent conceptual and methodological developments in the measurement and prediction of overcrowding in PEDs, building on the literature published since 2021. It conceptually examines unidimensional metrics, multidimensional scores, and emerging predictive models, emphasizing the shift from retrospective assessment to temporally oriented approaches and the need for pediatric-specific validation and multicenter evaluation.