Division of Endocrinology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
School of Medicine, National University of Ireland Galway, Galway, Ireland.
Diabetologia. 2020 Jun;63(6):1120-1127. doi: 10.1007/s00125-020-05123-6. Epub 2020 Mar 20.
AIMS/HYPOTHESIS: The aim of this systematic review was to develop core outcome sets (COSs) for trials evaluating interventions for the prevention or treatment of gestational diabetes mellitus (GDM).
We identified previously reported outcomes through a systematic review of the literature. These outcomes were presented to key stakeholders (including patient representatives, researchers and clinicians) for prioritisation using a three-round, e-Delphi study. A priori consensus criteria informed which outcomes were brought forward for discussion at a face-to-face consensus meeting where the COS was finalised.
Our review identified 74 GDM prevention and 116 GDM treatment outcomes, which were presented to stakeholders in round 1 of the e-Delphi study. Round 1 was completed by 173 stakeholders, 70% (121/173) of whom went on to complete round 2; 84% (102/121) of round 2 responders completed round 3. Twenty-two GDM prevention outcomes and 30 GDM treatment outcomes were discussed at the consensus meeting. Owing to significant overlap between included prevention and treatment outcomes, consensus meeting stakeholders agreed to develop a single prevention/treatment COS. Fourteen outcomes were included in the final COS. These consisted of six maternal outcomes (GDM diagnosis, adherence to the intervention, hypertensive disorders of pregnancy, requirement and type of pharmacological therapy for hyperglycaemia, gestational weight gain and mode of birth) and eight neonatal outcomes (birthweight, large for gestational age, small for gestational age, gestational age at birth, preterm birth, neonatal hypoglycaemia, neonatal death and stillbirth).
CONCLUSIONS/INTERPRETATION: This COS will enable future GDM prevention and treatment trials to measure similar outcomes that matter to stakeholders and facilitate comparison and combination of these studies.
This study was registered prospectively with the Core Outcome Measures in Effectiveness Trials (COMET) database: http://www.comet-initiative.org/studies/details/686/.
目的/假设:本系统评价的目的是为评估预防或治疗妊娠糖尿病(GDM)干预措施的试验制定核心结局集(COS)。
我们通过对文献的系统评价确定了先前报告的结局。这些结局通过三轮电子德尔菲研究向主要利益相关者(包括患者代表、研究人员和临床医生)展示,以进行优先排序。事先确定的共识标准确定了哪些结局将在面对面共识会议上进行讨论,以最终确定 COS。
我们的综述确定了 74 项 GDM 预防和 116 项 GDM 治疗结局,并在电子德尔菲研究的第一轮中向利益相关者展示。第一轮有 173 名利益相关者完成,其中 70%(121/173)继续完成第二轮;第二轮应答者中有 84%(102/121)完成了第三轮。22 项 GDM 预防结局和 30 项 GDM 治疗结局在共识会议上进行了讨论。由于纳入的预防和治疗结局之间存在显著重叠,共识会议利益相关者同意制定一个单一的预防/治疗 COS。最终的 COS 包括 14 项结局。这些结局包括 6 项产妇结局(GDM 诊断、对干预措施的依从性、妊娠高血压疾病、高血糖症所需和类型的药物治疗、妊娠期体重增加和分娩方式)和 8 项新生儿结局(出生体重、巨大儿、小于胎龄儿、出生时胎龄、早产、新生儿低血糖、新生儿死亡和死产)。
结论/解释:该 COS 将使未来的 GDM 预防和治疗试验能够衡量对利益相关者重要的类似结局,并促进这些研究的比较和组合。
本研究前瞻性地在有效性试验核心结局测量(COMET)数据库中注册:http://www.comet-initiative.org/studies/details/686/。