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Survey highlighting the lack of consensus on diagnosis and treatment of patent ductus arteriosus in prematurity

To gain insight in the availability of guidelines, diagnostic criteria, and treatment strategies and whether clinical equipoise regarding optimal treatment for patent ductus arteriosus (PDA) in prematurity is present. We hypothesized that (co-)authors of PDA-related papers were more likely to screen...

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Autores principales: Hundscheid, Tim, El-Khuffash, Afif, McNamara, Patrick J., de Boode, Willem P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9110525/
https://www.ncbi.nlm.nih.gov/pubmed/35305143
http://dx.doi.org/10.1007/s00431-022-04441-8
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author Hundscheid, Tim
El-Khuffash, Afif
McNamara, Patrick J.
de Boode, Willem P.
author_facet Hundscheid, Tim
El-Khuffash, Afif
McNamara, Patrick J.
de Boode, Willem P.
author_sort Hundscheid, Tim
collection PubMed
description To gain insight in the availability of guidelines, diagnostic criteria, and treatment strategies and whether clinical equipoise regarding optimal treatment for patent ductus arteriosus (PDA) in prematurity is present. We hypothesized that (co-)authors of PDA-related papers were more likely to screen for a PDA and would treat earlier and more aggressively. An international internet-based survey between September 2019 and March 2020 in which we collected (1) baseline characteristics; (2) availability of guidelines; (3) screening strategy for PDA; (4) diagnostic criteria for hemodynamic significance; (5) treatment strategy; and (6) metrics of treatment efficacy. Finally, ten clinical equipoise statements were posed on a Likert scale. In total, 144 surveys were sent, of which 71/144 (49%) surveys could be analyzed with 56/71 (79%) fully completed surveys. The respondents, mainly neonatologists in a level III neonatal intensive care unit, of whom 36/71 (51%) had (co-)authored a publication on the PDA, highlighted a lack of national guidelines, heterogeneous approach to screening strategies, and marked variability in diagnostic criteria to assess hemodynamic significance, treatment strategies and effect measurement. No major significant differences were observed between respondents who did or did not (co-)author a publication on the PDA. Respondents who screened for PDA scored significantly higher on the need for screening, early and aggressive treatment. Remarkably, the scores of all statements regarding clinical equipoise varied widely.    Conclusions: Our survey highlights the lack of guidelines and enormous heterogeneity in current practice. Current evidence is not robust enough to harmonize current treatment strategies into (inter)national guidelines. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00431-022-04441-8.
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spelling pubmed-91105252022-05-18 Survey highlighting the lack of consensus on diagnosis and treatment of patent ductus arteriosus in prematurity Hundscheid, Tim El-Khuffash, Afif McNamara, Patrick J. de Boode, Willem P. Eur J Pediatr Original Article To gain insight in the availability of guidelines, diagnostic criteria, and treatment strategies and whether clinical equipoise regarding optimal treatment for patent ductus arteriosus (PDA) in prematurity is present. We hypothesized that (co-)authors of PDA-related papers were more likely to screen for a PDA and would treat earlier and more aggressively. An international internet-based survey between September 2019 and March 2020 in which we collected (1) baseline characteristics; (2) availability of guidelines; (3) screening strategy for PDA; (4) diagnostic criteria for hemodynamic significance; (5) treatment strategy; and (6) metrics of treatment efficacy. Finally, ten clinical equipoise statements were posed on a Likert scale. In total, 144 surveys were sent, of which 71/144 (49%) surveys could be analyzed with 56/71 (79%) fully completed surveys. The respondents, mainly neonatologists in a level III neonatal intensive care unit, of whom 36/71 (51%) had (co-)authored a publication on the PDA, highlighted a lack of national guidelines, heterogeneous approach to screening strategies, and marked variability in diagnostic criteria to assess hemodynamic significance, treatment strategies and effect measurement. No major significant differences were observed between respondents who did or did not (co-)author a publication on the PDA. Respondents who screened for PDA scored significantly higher on the need for screening, early and aggressive treatment. Remarkably, the scores of all statements regarding clinical equipoise varied widely.    Conclusions: Our survey highlights the lack of guidelines and enormous heterogeneity in current practice. Current evidence is not robust enough to harmonize current treatment strategies into (inter)national guidelines. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00431-022-04441-8. Springer Berlin Heidelberg 2022-03-19 2022 /pmc/articles/PMC9110525/ /pubmed/35305143 http://dx.doi.org/10.1007/s00431-022-04441-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Hundscheid, Tim
El-Khuffash, Afif
McNamara, Patrick J.
de Boode, Willem P.
Survey highlighting the lack of consensus on diagnosis and treatment of patent ductus arteriosus in prematurity
title Survey highlighting the lack of consensus on diagnosis and treatment of patent ductus arteriosus in prematurity
title_full Survey highlighting the lack of consensus on diagnosis and treatment of patent ductus arteriosus in prematurity
title_fullStr Survey highlighting the lack of consensus on diagnosis and treatment of patent ductus arteriosus in prematurity
title_full_unstemmed Survey highlighting the lack of consensus on diagnosis and treatment of patent ductus arteriosus in prematurity
title_short Survey highlighting the lack of consensus on diagnosis and treatment of patent ductus arteriosus in prematurity
title_sort survey highlighting the lack of consensus on diagnosis and treatment of patent ductus arteriosus in prematurity
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9110525/
https://www.ncbi.nlm.nih.gov/pubmed/35305143
http://dx.doi.org/10.1007/s00431-022-04441-8
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