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关于单臂妊娠药物安全性研究中统计分析与报告建议的德尔菲法共识:调查妊娠、分娩及新生儿健康结局——IMI-ConcePTION项目的贡献

Delphi Method Consensus on Statistical Analysis and Reporting Recommendations for Single-Arm Pregnancy Medication Safety Studies Investigating Pregnancy, Birth and Neonatal Health Outcomes: A Contribution from IMI-ConcePTION.

作者信息

Richardson Jonathan L, Moore Alan, Stellfeld Michael, Geissbühler Yvonne, Winterfeld Ursula, Favre Guillaume, Chambers Christina, Beck Evelin, Onken Marlies, Dathe Katarina, Ceulemans Michael, Diav-Citrin Orna, Shechtman Svetlana, Oliver Alison M, Hodson Kenneth K, Shiller Dee-Dee, Alexe Amalia, van Puijenbroek Eugène P, Lewis David J, Yates Laura M

机构信息

UK Teratology Information Service, The Regional Drug and Therapeutics Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, 16/17 Framlington Place, Newcastle upon Tyne, Tyne and Wear, NE2 4AB, UK.

Novartis Pharma AG, 4002, Basel, Switzerland.

出版信息

Drug Saf. 2025 Jun;48(6):643-654. doi: 10.1007/s40264-025-01521-0. Epub 2025 Feb 5.


DOI:10.1007/s40264-025-01521-0
PMID:39907983
Abstract

BACKGROUND AND OBJECTIVE: Standardised procedures for performing and reporting safety monitoring studies investigating medications use in pregnancy may help improve data quality and the speed of data generation. The objective of this study was to provide recommendations on the statistical analysis and reporting of single-arm pregnancy medication safety studies using primary source datasets. METHODS: A Delphi consensus-setting protocol was used to acquire agreement on recommendations from experts with extensive knowledge and experience in conducting studies investigating medication safety in pregnancy. A series of recommendations, along with their scientific justifications and examples of how to calculate and describe exposure and outcome incidences, were critiqued and improved through a series of online Delphi review rounds. Agreement to inclusion scoring was assessed using a five-point Likert scale. Recommendations with a median Likert-scale score of at least 4, where ≥ 80% of the expert panel scored the recommendation at level 4 or higher, was used as the threshold for inclusion. RESULTS: The Delphi consensus methodology produced a set of 30 recommendations spread over five themes. These included descriptions of (1) study sample, (2) medication exposure, (3) maternal outcomes, (4) pregnancy and birth outcomes, and (5) fetal and neonatal outcomes. Of the 30 recommendations, 19 were strongly advised while 11 were included for consideration where their implementation may be beneficial for supplementing data communication. CONCLUSION: Use of the finalised set of recommendations should be encouraged to help standardise published evidence around medication use in pregnancy.

摘要

背景与目的:用于开展和报告调查孕期用药情况的安全性监测研究的标准化程序,可能有助于提高数据质量和数据生成速度。本研究的目的是针对使用原始数据集的单臂孕期用药安全性研究的统计分析和报告提供建议。 方法:采用德尔菲共识制定方案,以获取在开展孕期用药安全性研究方面具有丰富知识和经验的专家对各项建议的一致意见。一系列建议及其科学依据,以及关于如何计算和描述暴露与结局发生率的示例,通过一系列在线德尔菲评审轮次进行了批判和完善。使用五点李克特量表评估纳入评分的一致性。李克特量表中位数得分至少为4(专家小组中≥80%的成员将该建议评为4级或更高等级)的建议被用作纳入阈值。 结果:德尔菲共识方法产生了一组共30条建议,分布在五个主题中。这些主题包括对(1)研究样本、(2)药物暴露、(3)母亲结局、(4)妊娠和分娩结局,以及(5)胎儿和新生儿结局的描述。在这30条建议中,19条被强烈推荐,11条被纳入供考虑,其实施可能有助于补充数据交流。 结论:应鼓励使用最终确定的这组建议,以帮助规范已发表的关于孕期用药的证据。

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本文引用的文献

[1]
Improving Data Collection in Pregnancy Safety Studies: Towards Standardisation of Data Elements in Pregnancy Reports from Public and Private Partners, A Contribution from the ConcePTION Project.

Drug Saf. 2024-3

[2]
Expert consensus on neurodevelopmental outcomes in pregnancy pharmacovigilance studies.

Front Pharmacol. 2023-6-1

[3]
Core Data Elements for Pregnancy Pharmacovigilance Studies Using Primary Source Data Collection Methods: Recommendations from the IMI ConcePTION Project.

Drug Saf. 2023-5

[4]
From Inception to ConcePTION: Genesis of a Network to Support Better Monitoring and Communication of Medication Safety During Pregnancy and Breastfeeding.

Clin Pharmacol Ther. 2022-1

[5]
Online information discrepancies regarding safety of medicine use during pregnancy and lactation: an IMI ConcePTION study.

Expert Opin Drug Saf. 2021-9

[6]
Evaluation of Drug Labels Following the 2015 Pregnancy and Lactation Labeling Rule.

JAMA Netw Open. 2020-8-3

[7]
What are Delphi studies?

Evid Based Nurs. 2020-7

[8]
Prescription and Other Medication Use in Pregnancy.

Obstet Gynecol. 2018-5

[9]
Evolving knowledge of the teratogenicity of medications in human pregnancy.

Am J Med Genet C Semin Med Genet. 2011-7-15

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