Neonatal encephalopathy: a systematic review of reported treatment outcomes.


Journal

BMJ paediatrics open
ISSN: 2399-9772
Titre abrégé: BMJ Paediatr Open
Pays: England
ID NLM: 101715309

Informations de publication

Date de publication:
25 Sep 2024
Historique:
received: 18 02 2024
accepted: 04 08 2024
medline: 26 9 2024
pubmed: 26 9 2024
entrez: 25 9 2024
Statut: epublish

Résumé

Neonatal encephalopathy (NE) is a multi-organ condition potentially leading to death or long-term neurodisability. Therapeutic hypothermia is the standard treatment for NE; however, long-term impairments remain common. Studies of new treatments for NE often measure and report different outcomes. Core outcome sets (COSs), a minimum set of outcomes to be measured and reported in all studies for a condition, address this problem. This paper aimed to identify outcomes reported (primary, secondary, adverse events and other reported outcomes) in (1) randomised trials and (2) systematic reviews of randomised trials of interventions for the treatment of NE in the process of developing a COS for interventions for the treatment of NE. We completed a systematic search for outcomes used to evaluate treatments for NE using MEDLINE, Embase, Cochrane CENTRAL, the Cochrane Database of Systematic Reviews and the WHO International Clinical Trials Registry Platform. Two reviewers screened all included articles independently. Outcomes were extracted verbatim, similar outcomes were grouped and outcome domains were developed. 386 outcomes were reported in 116 papers, from 85 studies. Outcomes were categorised into 18 domains. No outcome was reported by all studies, a single study reported 11 outcomes and it was not explicitly stated that outcomes had input from parents. Heterogeneity in reported outcomes means that synthesis of studies evaluating new treatments for NE remains difficult. A COS, that includes parental/family input, is needed to ensure consistency in measuring and reporting outcomes, and to enable comparison of randomised trials.

Sections du résumé

BACKGROUND BACKGROUND
Neonatal encephalopathy (NE) is a multi-organ condition potentially leading to death or long-term neurodisability. Therapeutic hypothermia is the standard treatment for NE; however, long-term impairments remain common. Studies of new treatments for NE often measure and report different outcomes. Core outcome sets (COSs), a minimum set of outcomes to be measured and reported in all studies for a condition, address this problem. This paper aimed to identify outcomes reported (primary, secondary, adverse events and other reported outcomes) in (1) randomised trials and (2) systematic reviews of randomised trials of interventions for the treatment of NE in the process of developing a COS for interventions for the treatment of NE.
METHODS METHODS
We completed a systematic search for outcomes used to evaluate treatments for NE using MEDLINE, Embase, Cochrane CENTRAL, the Cochrane Database of Systematic Reviews and the WHO International Clinical Trials Registry Platform. Two reviewers screened all included articles independently. Outcomes were extracted verbatim, similar outcomes were grouped and outcome domains were developed.
RESULTS RESULTS
386 outcomes were reported in 116 papers, from 85 studies. Outcomes were categorised into 18 domains. No outcome was reported by all studies, a single study reported 11 outcomes and it was not explicitly stated that outcomes had input from parents.
DISCUSSION CONCLUSIONS
Heterogeneity in reported outcomes means that synthesis of studies evaluating new treatments for NE remains difficult. A COS, that includes parental/family input, is needed to ensure consistency in measuring and reporting outcomes, and to enable comparison of randomised trials.

Identifiants

pubmed: 39322607
pii: 10.1136/bmjpo-2024-002510
doi: 10.1136/bmjpo-2024-002510
pii:
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Fiona Quirke (F)

Neonatal Encephalopathy PhD Training Network, Health Research Board, Dublin, Ireland 22306056@studentmail.ul.ie.
Health Research Board -Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland.

Linda Biesty (L)

School of Nursing & Midwifery, University of Galway, Galway, Ireland.
Evidence Synthesis Ireland, University of Galway, Galway, Ireland.

Malcolm Battin (M)

Auckland City Hospital, Auckland, New Zealand.

Frank Harry Bloomfield (FH)

Liggins Institute, University of Auckland, Auckland, New Zealand.

Mandy Daly (M)

Advocacy and Policymaking Irish Neonatal Health Alliance, Wicklow, Ireland.

Elaine Finucane (E)

Evidence Synthesis Ireland, University of Galway, Galway, Ireland.

Patricia Healy (P)

School of Nursing & Midwifery, University of Galway, Galway, Ireland.

Tim Hurley (T)

Neonatal Encephalopathy PhD Training Network, Health Research Board, Dublin, Ireland.

Jamie J Kirkham (JJ)

Centre for Biostatistics, Manchester Academic Health Science Centre, Manchester University, Manchester, UK.

Eleanor Molloy (E)

Paediatrics, Trinity College Dublin, Dublin, Ireland.
Paediatrics, Tallaght Hospital, Dublin, Ireland.

David M Haas (DM)

Department of Obstetrics and Gynecology, Indiana University, Bloomington, Indiana, USA.

Shireen Meher (S)

Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.

Elaine Ní Bhraonáin (E)

Irish Neonatal Health Alliance, Wicklow, Ireland.

Karen Walker (K)

Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
The University of Sydney, Sydney, New South Wales, Australia.

James Webbe (J)

Academic Neonatal Medicine, Imperial College London, London, UK.

Declan Devane (D)

Health Research Board -Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland.
Evidence Synthesis Ireland, University of Galway, Galway, Ireland.

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