Core outcomes in neonatology: development of a core outcome set for neonatal research.

James William Harrison Webbe, James M N Duffy, Elsa Afonso, Iyad Al-Muzaffar, Ginny Brunton, Anne Greenough, Nigel J Hall, Marian Knight, Jos M Latour, Caroline Lee-Davey, Neil Marlow, Laura Noakes, Julie Nycyk, Angela Richard-Löndt, Ben Wills-Eve, Neena Modi, Chris Gale

Journal: Archives of disease in childhood. Fetal and neonatal edition 2020;105(4):425-431

PMID: 31732683

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Abstract

BACKGROUND

Neonatal research evaluates many different outcomes using multiple measures. This can prevent synthesis of trial results in meta-analyses, and selected outcomes may not be relevant to former patients, parents and health professionals.

OBJECTIVE

To define a core outcome set (COS) for research involving infants receiving neonatal care in a high-income setting.

DESIGN

Outcomes reported in neonatal trials and qualitative studies were systematically reviewed. Stakeholders were recruited for a three-round international Delphi survey. A consensus meeting was held to confirm the final COS, based on the survey results.

PARTICIPANTS

Four hundred and fourteen former patients, parents, healthcare professionals and researchers took part in the eDelphi survey; 173 completed all three rounds. Sixteen stakeholders participated in the consensus meeting.

RESULTS

The literature reviews identified 104 outcomes; these were included in round 1. Participants proposed 10 additional outcomes; 114 outcomes were scored in rounds 2 and 3. Round 1 scores showed different stakeholder groups prioritised contrasting outcomes. Twelve outcomes were included in the final COS: survival, sepsis, necrotising enterocolitis, brain injury on imaging, general gross motor ability, general cognitive ability, quality of life, adverse events, visual impairment/blindness, hearing impairment/deafness, retinopathy of prematurity and chronic lung disease/bronchopulmonary dysplasia.

CONCLUSIONS AND RELEVANCE

A COS for clinical trials and other research studies involving infants receiving neonatal care in a high-income setting has been identified. This COS for neonatology will help standardise outcome selection in clinical trials and ensure these are relevant to those most affected by neonatal care.

Address: Academic Neonatal Medicine, Imperial College London, London, UK [email protected].; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK.; Neonatal Unit, Rosie Hospital, Cambridge, Cambridgeshire, UK.; The Neonatal Unit, Royal Glamorgan Hospital, Llantrisant, Rhondda Cynon Taf, UK.; UCL Institute of Education Centre for Longitudinal Studies, London, UK.; Department of Women and Children's Health, School of Life Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.; Paediatric Surgery, Southampton General Hospital, Southampton, UK.; National Perinatal Epidemiology Unit, Oxford, UK.; School of Nursing and Midwifery, Faculty of Health, Education and Society, Plymouth University, Plymouth, Devon, UK.; School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.; Bliss, London, UK.; Institute for Women's Health, University College London, London, UK.; Parent of Neonatal Patient, London, UK.; Neonatal Unit, Birmingham City Hospital, Birmingham, UK.; Former neonatal patient, London, UK.; Neonatal Medicine, Imperial College London, London, UK.; Academic Neonatal Medicine, Imperial College London, London, UK.

DOI: 10.1136/archdischild-2019-317501

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MeSH Terms: Biomedical Research, Humans, Infant, Neonatology, Outcome Assessment, Health Care