Core outcome set for studies investigating management of selective fetal growth restriction in twins.


Journal

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
ISSN: 1469-0705
Titre abrégé: Ultrasound Obstet Gynecol
Pays: England
ID NLM: 9108340

Informations de publication

Date de publication:
05 2020
Historique:
received: 28 03 2019
revised: 07 06 2019
accepted: 21 06 2019
pubmed: 6 7 2019
medline: 27 11 2021
entrez: 6 7 2019
Statut: ppublish

Résumé

Selective fetal growth restriction (sFGR) occurs in monochorionic twin pregnancies when unequal placental sharing leads to restriction in the growth of just one twin. Management options include laser separation of the fetal circulations, selective reduction or expectant management, but what constitutes the best treatment is not yet known. New trials in this area are urgently needed but, in this rare and complex group, maximizing the relevance and utility of clinical research design and outputs is paramount. A core outcome set ensures standardized outcome collection and reporting in future research. The objective of this study was to develop a core outcome set for studies evaluating treatments for sFGR in monochorionic twins. An international steering group of clinicians, researchers and patients with experience of sFGR was established to oversee the process of development of a core outcome set for studies investigating the management of sFGR. Outcomes reported in the literature were identified through a systematic review and informed the design of a three-round Delphi survey. Clinicians, researchers, and patients and family representatives participated in the survey. Outcomes were scored on a Likert scale from 1 (limited importance for making a decision) to 9 (critical for making a decision). Consensus was defined a priori as a Likert score of ≥ 8 in the third round of the Delphi survey. Participants were then invited to take part in an international meeting of stakeholders in which the modified nominal group technique was used to consider the consensus outcomes and agree on a final core outcome set. Ninety-six outcomes were identified from 39 studies in the systematic review. One hundred and three participants from 23 countries completed the first round of the Delphi survey, of whom 88 completed all three rounds. Twenty-nine outcomes met the a priori criteria for consensus and, along with six additional outcomes, were prioritized in a consensus development meeting, using the modified nominal group technique. Twenty-five stakeholders participated in this meeting, including researchers (n = 3), fetal medicine specialists (n = 3), obstetricians (n = 2), neonatologists (n = 3), midwives (n = 4), parents and family members (n = 6), patient group representatives (n = 3), and a sonographer. Eleven core outcomes were agreed upon. These were live birth, gestational age at birth, birth weight, intertwin birth-weight discordance, death of surviving twin after death of cotwin, loss during pregnancy or before final hospital discharge, parental stress, procedure-related adverse maternal outcome, length of neonatal stay in hospital, neurological abnormality on postnatal imaging and childhood disability. This core outcome set for studies investigating the management of sFGR represents the consensus of a large and diverse group of international collaborators. Use of these outcomes in future trials should help to increase the clinical relevance of research on this condition. Consensus agreement on core outcome definitions and measures is now required. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Identifiants

pubmed: 31273879
doi: 10.1002/uog.20388
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

652-660

Investigateurs

Ahmet Baschat (A)
Alfredo Perales-Marin (A)
Anthony Johnson (A)
Arduino Silvana (A)
Aris Papageorghious (A)
Ashok Khurana (A)
Asma Khalil (A)
Bonnie Trinder (B)
C Andrew Combs (CA)
Carolyn Bailie (C)
Charlotte Huddy (C)
Christie Bolch (C)
Conrado Milani Coutinho (CM)
Daniel Skupski (D)
Danielle Hake (D)
Dick Oepkes (D)
Dietmar Schlembach (D)
Eduardo Gratacos (E)
Eleanor Lindahl (E)
Elena Carreras (E)
Elena Mantovani (E)
Elisa Giallongo (E)
Emily Marler (E)
Emma Bertucci (E)
Enrico Lopriore (E)
Federico Prefumo (F)
Filomena G Sileo (FG)
Gavin Guy (G)
Giuseppe Rizzo (G)
Hayley King (H)
Helen Perry (H)
Herbert Valensise (H)
Hiran Samarage (H)
James Duffy (J)
Jan Deprest (J)
Jane Denton (J)
Joana Curado (J)
Joel Marsden (J)
Jorge E Tolosa (JE)
Joseph Toms (J)
Joshua Copel (J)
Justin Richards (J)
Keisuke Ishii (K)
Keith Reed (K)
Kirsten Palmer (K)
Kirsty Watkins (K)
Kurt Hecher (K)
Liesbeth Lewi (L)
Lindsay McGrath (L)
Lisa Canolini (L)
Mala Vast Dhuri (MV)
Maria Kyriakidou (M)
Mariano Lanna (M)
Marjorie Treadwell (M)
Michelle Watson (M)
Monica Rankin (M)
Natasha Fenwick (N)
Pablo Moore (P)
Patrick O'Brien (P)
Robert Cincotta (R)
Rosemary Townsend (R)
Sandra Linton (S)
Sanne J Gordijn (SJ)
Sophie Robinson (S)
Therese McSorley (T)
Tomasz Fuchs (T)
Tullio Ghi (T)
Wessel Ganzevoort (W)
Wunmi Omosebi (W)
Yaa Acheampong (Y)

Informations de copyright

Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Références

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Auteurs

R Townsend (R)

Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK.
Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St George's University Hospitals NHS Foundation Trust, University of London, London, UK.

J M N Duffy (JMN)

Balliol College, University of Oxford, Oxford, UK.
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.

F Sileo (F)

Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St George's University Hospitals NHS Foundation Trust, University of London, London, UK.

H Perry (H)

Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK.
Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St George's University Hospitals NHS Foundation Trust, University of London, London, UK.

W Ganzevoort (W)

Department of Obstetrics and Gynecology, Academic Medical Center Amsterdam, University of Amsterdam, Amsterdam, The Netherlands.

K Reed (K)

Twin and Multiple Births Association (TAMBA), Aldershot, UK.

A A Baschat (AA)

The Johns Hopkins Center for Fetal Therapy, Baltimore, MD, USA.

J Deprest (J)

Department of Obstetrics and Gynecology, University Hospitals of KU Leuven, Leuven, Belgium.

E Gratacos (E)

Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, Universitat de Barcelona, Barcelona, Spain.
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.

K Hecher (K)

Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

L Lewi (L)

Department of Obstetrics and Gynecology, University Hospitals of KU Leuven, Leuven, Belgium.

E Lopriore (E)

Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands.

D Oepkes (D)

Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.

A Papageorghiou (A)

Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St George's University Hospitals NHS Foundation Trust, University of London, London, UK.

S J Gordijn (SJ)

Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

A Khalil (A)

Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK.
Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St George's University Hospitals NHS Foundation Trust, University of London, London, UK.

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