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综合队列研究结局研究的核心结局集:系统评价。

Synthesizing Core Outcome Sets for outcomes research in cohort studies: a systematic review.

机构信息

Murdoch Children's Research Institute, Parkville, VIC, Australia.

Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.

出版信息

Pediatr Res. 2022 Oct;92(4):936-945. doi: 10.1038/s41390-021-01801-2. Epub 2021 Dec 17.

Abstract

BACKGROUND

Life course studies are designed to "collect once, use multiple times" for observational and, increasingly, interventional research. Core Outcome Sets (COS) are minimum sets developed for clinical trials by multi-stakeholder consensus methodologies. We aimed to synthesize published COS that might guide outcomes selection for early life cohorts with an interventional focus.

METHODS

We searched PubMed, Medline, COMET, and CROWN for COS published before January 2021 relevant to four life stages (pregnancy, newborns, children <8 years, and parents (adults aged 18-50 years)). We synthesized core outcomes into overarching constructs.

RESULTS

From 46 COS we synthesized 414 core outcomes into 118 constructs. "Quality of life", "adverse events", "medication use", "hospitalization", and "mortality" were consistent across all stages. For pregnancy, common constructs included "preterm birth", "delivery mode", "pre-eclampsia", "gestational weight gain", "gestational diabetes", and "hemorrhage"; for newborns, "birthweight", "small for gestational age", "neurological damage", and "morbidity" and "infection/sepsis"; for pediatrics, "pain", "gastrointestinal morbidity", "growth/weight", "breastfeeding", "feeding problems", "hearing", "neurodevelopmental morbidity", and "social development"; and for adults, "disease burden", "mental health", "neurological function/stroke", and "cardiovascular health/morbidity".

CONCLUSION

This COS synthesis generated outcome constructs that are of high value to stakeholders (participants, health providers, services), relevant to life course research, and could position cohorts for trial capabilities.

IMPACT

We synthesized existing Core Outcome Sets as a transparent methodology that could prioritize outcomes for lifecourse cohorts with an interventional focus. "Quality of life", "adverse events", "medication use", "hospitalization", and "mortality" are important outcomes across pregnancy, newborns, childhood, and early-to-mid-adulthood (the age range relevant to parents). Other common outcomes (such as "birthweight", "cognitive function/ability", "psychological health") are also highly relevant to lifecourse research. This synthesis could assist new early life cohorts to pre-select outcomes that are of high value to stakeholders (participants, health providers, services), are relevant to lifecourse research, and could position them for future trials and interventional capability.

摘要

背景

生命历程研究旨在“一次性收集,多次使用”,用于观察性研究,并且越来越多地用于干预性研究。核心结局集(COS)是由多利益相关者共识方法为临床试验制定的最小数据集。我们旨在综合已发表的 COS,以指导以干预为重点的早期生命队列的结局选择。

方法

我们在 PubMed、Medline、COMET 和 CROWN 中检索了 2021 年 1 月之前发表的与四个生命阶段(妊娠、新生儿、<8 岁儿童和父母(18-50 岁成年人))相关的 COS。我们将核心结局综合为总体结构。

结果

从 46 个 COS 中,我们综合了 414 个核心结局,形成了 118 个结构。“生活质量”、“不良事件”、“药物使用”、“住院”和“死亡率”在所有阶段都是一致的。对于妊娠,常见的结构包括“早产”、“分娩方式”、“子痫前期”、“妊娠体重增加”、“妊娠糖尿病”和“出血”;对于新生儿,“出生体重”、“小于胎龄儿”、“神经损伤”和“发病率”和“感染/败血症”;对于儿科,“疼痛”、“胃肠道发病率”、“生长/体重”、“母乳喂养”、“喂养问题”、“听力”、“神经发育发病率”和“社会发展”;对于成年人,“疾病负担”、“心理健康”、“神经功能/中风”和“心血管健康/发病率”。

结论

本 COS 综合生成了对利益相关者(参与者、卫生提供者、服务)具有高价值、与生命历程研究相关且可使队列具有试验能力的结局结构。

影响

我们综合了现有的核心结局集,作为一种透明的方法,可以为以干预为重点的生命历程队列确定优先结局。“生活质量”、“不良事件”、“药物使用”、“住院”和“死亡率”在妊娠、新生儿、儿童和早中年(与父母相关的年龄范围)期间都是重要的结局。其他常见的结局(如“出生体重”、“认知功能/能力”、“心理健康”)也与生命历程研究密切相关。本综合可以帮助新的早期生命队列预先选择对利益相关者(参与者、卫生提供者、服务)具有高价值、与生命历程研究相关且可以为他们未来的试验和干预能力定位的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a35/8678579/117e0b07f001/41390_2021_1801_Fig1_HTML.jpg

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