A systematic review of outcome reporting in childhood pneumonia trials.
PHE ePoster Library. Ali S. Sep 10, 2018; 221303; 115
Shohaib Ali
Shohaib Ali
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Abstract
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Abstract Introduction: Pneumonia is the largest killer of children <5 worldwide, with the majority of deaths happening in LMICs. Recent Cochrane reviews highlight concerns around definitions and outcome reporting. Furthermore, recent WHO guidelines question the generalisability of current studies. This review aims to explore what definitions and outcomes are used by pneumonia trials.Methodology: This systematic review looked at children (2-59 months) receiving any pneumonia intervention in the community/hospitals in LMICs. Individual and cluster RCTs were included. MEDLINE and EMBASE were searched (2007-2017), using a pre-defined search criteria. The study was prospectively registered on PROSPERO: CRD42018092777. Results: 5614 papers were identified, after removing duplicates, 3915 were screened on title and abstract. 163 were screened on full text. 61 were included in the review. 53% (n=32) of trials used the WHO pneumonia definition. 13 different primary outcomes were selected, the most common was treatment failure (TF) (n=22). For TF; key domains, including mortality, were not included in the composite outcome by all trials (n=18). 41% of trials reported their primary outcome at day 7 or earlier. No trial reported patient/parental involvement in outcome selection. For generalisability; studies were conducted in India (n=15), Pakistan (n=7), with most studies conducted in a hospital setting (n=48).Discussion: There is a clear heterogeneity in pneumonia definitions and outcome reporting. One solution is to develop a core outcome set for pneumonia trials. These involve having a defined set of predefined outcomes developed by multiple stakeholders. This would ensure researchers collect meaningful outcome data. External funding details No external funding sources.
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