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极早产儿队列的神经发育结局描述。

Neurodevelopmental outcome descriptions in cohorts of extremely preterm children.

机构信息

Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

CHEO Research Institute, Ottawa, Ontario, Canada.

出版信息

Arch Dis Child Fetal Neonatal Ed. 2020 Sep;105(5):510-519. doi: 10.1136/archdischild-2019-318144. Epub 2020 Jan 13.

Abstract

BACKGROUND AND OBJECTIVES

Caregivers and clinicians of extremely preterm infants (born before 26 weeks' gestation) depend on long-term follow-up research to inform clinical decision-making. The completeness of outcome reporting in this area is unknown. The objective of this study was to evaluate the reporting of outcome definitions, selection, measurement and analysis in existing cohort studies that report on neurodevelopmental outcomes of children born extremely preterm.

METHODS

We evaluated the completeness of reporting of 'cognitive function' and 'cerebral palsy' in prospective cohort studies summarised in a meta-analysis that assessed the effect of preterm birth on school-age neurodevelopment. Outcome reporting was evaluated using a checklist of 55 items addressing outcome selection, definition, measurement, analysis, presentation and interpretation. Reporting frequencies were calculated to identify strengths and deficiencies in outcome descriptions.

RESULTS

All 14 included studies reported 'cognitive function' as an outcome; nine reported both 'cognitive function' and 'cerebral palsy' as outcomes. Studies reported between 26% and 46% of the 55 outcome reporting items assessed; results were similar for 'cognitive function' and 'cerebral palsy' (on average 34% and 33% of items reported, respectively). Key methodological concepts often omitted included the reporting of masking of outcome assessors, methods used to handle missing data and stakeholder involvement in outcome selection.

CONCLUSIONS

The reporting of neurodevelopmental outcomes in cohort studies of infants born extremely preterm is variable and often incomplete. This may affect stakeholders' interpretation of study results, impair knowledge synthesis efforts and limit evidence-based decision-making for this population.

摘要

背景与目的

极早产儿(妊娠 26 周前出生)的照料者和临床医生依赖长期随访研究来为临床决策提供信息。目前尚不清楚该领域结局报告的完整性。本研究旨在评估现有报道极早产儿神经发育结局的队列研究中结局定义、选择、测量和分析的报告情况。

方法

我们使用一份包含 55 项内容的清单评估了汇总在一项评估早产对学龄期神经发育影响的荟萃分析中的前瞻性队列研究中“认知功能”和“脑瘫”的报告完整性。该清单涵盖了结局选择、定义、测量、分析、呈现和解释等方面。通过计算报告频率,我们确定了结局描述中的优势和不足。

结果

所有 14 项纳入的研究均报道了“认知功能”作为结局;9 项研究同时报道了“认知功能”和“脑瘫”作为结局。研究报告了 55 项结局报告项目中的 26%至 46%;对于“认知功能”和“脑瘫”,结果相似(分别报告了 34%和 33%的项目)。经常遗漏的关键方法学概念包括结局评估者的盲法报告、处理缺失数据的方法以及利益相关者在结局选择中的参与。

结论

报道极早产儿队列研究的神经发育结局的报告情况存在差异,且往往不完整。这可能会影响利益相关者对研究结果的解释,影响知识综合工作,并限制该人群的循证决策。

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