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制定孕前糖尿病孕妇治疗的核心结局集:研究方案。

Developing a core outcome set for the treatment of pregnant women with pregestational diabetes-a study protocol.

机构信息

School of Medicine, National University of Ireland Galway, Galway, Ireland.

Department of Endocrinology, Mayo Clinic Rochester, Rochester, MN, USA.

出版信息

Trials. 2020 Dec 11;21(1):1017. doi: 10.1186/s13063-020-04910-1.

Abstract

BACKGROUND

Pregestational diabetes mellitus (PGDM) is associated with adverse pregnancy outcomes including increased rates of caesarean section birth, macrosomia, congenital malformation, prematurity, admission to the neonatal intensive care unit and stillbirth. As a result, there has been an increase in interventions to improve outcomes in both mother and infant. To date, meaningful comparisons between these studies are limited due to heterogeneity in outcome selection and reporting. The aim of this study is to develop a core outcome set (COS) for randomised controlled trials evaluating the effectiveness of interventions for the treatment of pregnant women with PGDM.

METHODS

The study consists of three steps. The first step is a systematic review of the literature to assess outcomes reported in randomised controlled trials assessing the effectiveness of interventions for the treatment of pregnant women with PGDM. The second step is a three round, online Delphi survey to prioritise these outcomes. In this step, stakeholders (including women with PGDM, healthcare workers, researchers and policymakers) will be asked to rank the importance of outcomes for inclusion in the COS using a 9-point Likert type scale. Outcomes that meet the inclusion criteria after completion of the Delphi surveys will be brought to the consensus meeting. The consensus meeting will be the third and final step, where the COS will be finalised. The consensus meeting will include members from each stakeholder group.

DISCUSSION

This paper describes the process used to develop a COS for the reporting of studies evaluating the effectiveness of interventions in pregnant women with PGDM. The COS will enable greater comparison between and information synthesis across RCTs in the treatment of PGDM. In addition, this COS will also help improve trial reporting and minimise research waste by prioritising the collection and reporting of outcomes that matter to all relevant stakeholder groups.

TRIAL REGISTRATION

This COS has been registered with the Core Outcome Measures in Effectiveness Trials (COMET) initiative ( http://www.comet-initiative.org/studies/details/1425 ) on the 4th of November 2019. The systematic review component of this study has also been registered with the International Prospective Register of Systematic Reviews (PROSPERO) ( https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020173549 ).

摘要

背景

孕前糖尿病(PGDM)与不良妊娠结局相关,包括剖宫产率增加、巨大儿、先天畸形、早产、新生儿重症监护病房入院和死产。因此,为了改善母婴结局,干预措施有所增加。迄今为止,由于研究结果选择和报告的异质性,这些研究之间的有意义比较受到限制。本研究旨在为评估治疗 PGDM 孕妇干预措施有效性的随机对照试验制定核心结局集(COS)。

方法

该研究包括三个步骤。第一步是系统回顾文献,评估评估 PGDM 孕妇治疗干预措施有效性的随机对照试验报告的结果。第二步是三轮在线 Delphi 调查,对这些结果进行优先排序。在这一步中,利益相关者(包括 PGDM 妇女、医护人员、研究人员和政策制定者)将被要求使用 9 分 Likert 量表对纳入 COS 的结果的重要性进行排名。在 Delphi 调查完成后,符合纳入标准的结果将被带到共识会议上。共识会议将是第三步也是最后一步,届时将确定 COS。共识会议将包括每个利益相关者组的成员。

讨论

本文描述了用于制定报告评估 PGDM 孕妇干预措施有效性研究的 COS 的过程。COS 将使 PGDM 治疗中 RCT 之间的比较和信息综合更加容易。此外,该 COS 还将通过优先考虑对所有相关利益相关者群体都重要的结果的收集和报告,帮助改善试验报告并减少研究浪费。

试验注册

该 COS 已于 2019 年 11 月 4 日在核心疗效试验结局测量(COMET)倡议(http://www.comet-initiative.org/studies/details/1425)上注册。本研究的系统评价部分也已在国际前瞻性系统评价登记册(PROSPERO)(https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020173549)上注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cf7/7730783/472d2e19de1f/13063_2020_4910_Fig1_HTML.jpg

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