Decreasing Number of Conclusive Neonatal Reviews: Increasing Role for Shared Decision-Making?

Lai, Nai Ming; Ong, Joni Mei Jun; Chen, Kee Hsin; Chaiyakunapruk, Nathorn; Ovelman, Colleen; Soll, Roger F.

doi:10.1159/000502492

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…Neonatal research is an area of great global need and universal importance. Yet, only 2.5% of trials in the Cochrane Central Register involve neonates [1], over two-thirds of Cochrane neonatal reviews are inconclusive because included trials are too small and/or methodologically weak [2], and the number of neonatal trials is diminishing [3]. Only one medicine, surfactant, has ever been developed specifically for neonates [4] and over 90% of medicines for neonates are prescribed off-label or off-license, increasing the risk of adverse effects as efficacy, safety, and dose data are inadequate [5].…”

Section: Need and Importancementioning

confidence: 99%

The future of perinatal research

Modi

2022

Eur J Pediatr

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Perinatal clinical, biomedical, and life sciences research are important means of improving the health and wellbeing of mothers and infants, and as health in infancy can establish life-long trajectories, adult health as well. In this brief paper, I will discuss the need for and importance of perinatal research, some of the many challenges facing this at the present time, the damage arising from continuing as we are, and the benefits of adopting a new approach. I suggest a way forward, accepting that this will not be easy.

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Section: Need and Importancementioning

confidence: 99%

The future of perinatal research

Modi

2022

Eur J Pediatr

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Protecting patients against clinician bias

Modi

2023

Arch Dis Child

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Are Newer Drugs Better? An Analysis of Neonatal Pharmacological Treatments across Generations

Lai,

Veettil,

Chaiyakunapruk

et al. 2024

Med Princ Pract

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Introduction: We evaluated the relative effects of newer versus older medications for neonatal conditions and trends in margin of superiority across generations. Materials and Methods: We assessed network meta-analyses (NMAs) on neonatal pharmacological interventions identified from Medline, Cochrane, and PROSPERO. Interventions were chronologically arranged based on the earliest study and compared for their effects against placebo or no treatment and their immediate predecessor. We assessed the time trend in effect sizes using the Mann-Kendall test. Results: From 8048 retrieved records, 10 neonatal NMAs covering 352 trials and 102,653 participants were included. Compared to placebo, 56/61 (91.8%) interventions showed superiority with 23 (37.7%) statistically significant. Compared to previous generation, 47/72 (65.3%) showed superiority with 3 (4.2%) statistically significant. No significant trends in effect sizes were observed across generations for most conditions (p = 0.09 to 1). Conclusions: We found no evidence that newer-generation medications in neonatal care are consistently more effective than older-generation medications.

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Decreasing Number of Conclusive Neonatal Reviews: Increasing Role for Shared Decision-Making?

Cited by 3 publications

References 5 publications

The future of perinatal research

The future of perinatal research

Protecting patients against clinician bias

Are Newer Drugs Better? An Analysis of Neonatal Pharmacological Treatments across Generations

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