Neonatal sepsis: a systematic review of core outcomes from randomised clinical trials
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Published version
Author(s)
Type
Journal Article
Abstract
BACKGROUND: The lack of a consensus definition of neonatal sepsis and a core outcome set (COS) proves a substantial impediment to research that influences policy and practice relevant to key stakeholders, patients and parents. METHODS: A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. In the included studies, the described outcomes were extracted in accordance with the provisions of the Core Outcome Measures in Effectiveness Trials (COMET) handbook and registered. RESULTS: Among 884 abstracts identified, 90 randomised controlled trials (RCTs) were included in this review. Only 30 manuscripts explicitly stated the primary and/or secondary outcomes. A total of 88 distinct outcomes were recorded across all 90 studies included. These were then assigned to seven different domains in line with the taxonomy for classification proposed by the COMET initiative. The most frequently reported outcome was survival with 74% (n = 67) of the studies reporting an outcome within this domain. CONCLUSIONS: This systematic review constitutes one of the initial phases in the protocol for developing a COS in neonatal sepsis. The paucity of standardised outcome reporting in neonatal sepsis hinders comparison and synthesis of data. The final phase will involve a Delphi Survey to generate a COS in neonatal sepsis by consensus recommendation. IMPACT: This systematic review identified a wide variation of outcomes reported among published RCTs on the management of neonatal sepsis. The paucity of standardised outcome reporting hinders comparison and synthesis of data and future meta-analyses with conclusive recommendations on the management of neonatal sepsis are unlikely. The final phase will involve a Delphi Survey to determine a COS by consensus recommendation with input from all relevant stakeholders.
Date Issued
2022-01-07
Date Acceptance
2021-10-28
Citation
Pediatric Research, 2022, 91
ISSN
0031-3998
Publisher
Springer Nature [academic journals on nature.com]
Journal / Book Title
Pediatric Research
Volume
91
Copyright Statement
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/34997225
PII: 10.1038/s41390-021-01883-y
Subjects
Science & Technology
Life Sciences & Biomedicine
Pediatrics
COLONY-STIMULATING FACTOR
PLACEBO-CONTROLLED TRIAL
ENRICHED INTRAVENOUS IMMUNOGLOBULIN
EARLY-ONSET SEPSIS
ORAL ZINC SUPPLEMENTATION
IMMUNE GLOBULIN THERAPY
BUFFY COAT TRANSFUSIONS
DAYS ANTIBIOTIC-THERAPY
GUIDED DECISION-MAKING
BIRTH-WEIGHT INFANTS
Delphi Technique
Humans
Infant, Newborn
Neonatal Sepsis
Outcome Assessment, Health Care
Randomized Controlled Trials as Topic
Research Design
Treatment Outcome
Infection, Inflammation, Immunology and Immunisation (I4) section of the European Society for Paediatric Research (ESPR)
Pediatrics
1114 Paediatrics and Reproductive Medicine
1117 Public Health and Health Services
Publication Status
Published online
Coverage Spatial
United States
Date Publish Online
2022-01-07