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Most cited protocols related to «Neonatologists»

We conducted a systematic review to develop an international clinical practice guideline in accord with the World Health Organization’s Handbook for Guideline Development15 and the Institute of Medicine’s standards.16 We followed the Equator Network reporting recommendations outlined in the Appraisal of Guidelines, Research and Evaluation (AGREE) II instrument17 (link) and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement.18 We systematically searched MEDLINE (1956–2016), EMBASE (1980–2016), CINAHL (1983–2016), and the Cochrane Library (1988–2016) and hand searched using the following terms: cerebral palsy, diagnosis, detection, prediction, identification, predictive validity, accuracy, sensitivity, and specificity. We included systematic reviews with or without meta-analyses, criteria of diagnostic accuracy, and evidence-based clinical guidelines. Quality was appraised using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) methodological rating checklist for systematic reviews of diagnostic accuracy.19 (link)The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was used to assess quality and formulate recommendations along a 4-part continuum, including strong for, conditional for, conditional against, and strong against.20 (link) As per the GRADE method, we weighed (1) the balance between desirable and undesirable consequences of different management strategies or not acting; (2) family preferences, including benefits vs risks and inconvenience; and (3) cost. Recommendations were discussed face-to-face among all authors, and the manuscript was reviewed, edited, and agreed on by all coauthors. Authors were clinicians involved in the diagnosis of cerebral palsy, including neurologists, pediatricians, neonatologists, rehabilitation specialists, general practitioners, neuroradiologists, psychiatrists, physical therapists, psychologists, occupational therapists, speech pathologists, nurses, and early educators. Individuals with cerebral palsy and parents also contributed as equal authors, ensuring that recommendations addressed their views and preferences.
Publication 2017
cDNA Library Cerebral Palsy Diagnosis Face General Practitioners Hypersensitivity Neonatologists Neurologists Nurses Occupational Therapist Parent Pathologists Pediatricians Physical Therapist Psychiatrist Rehabilitation Specialists Speech Tests, Diagnostic
A protocol with explicitly defined objectives, formal consensus development methods, criteria for participant identification and selection, and statistical methods was developed. The study was prospectively registered with the Core Outcome Measures in Effectiveness Trials (COMET) initiative (registration number 603 available online at www.comet-initiative.org/studies/details/603). The ethics board of the Academic Medical Center, Amsterdam, The Netherlands, advised that ethical approval was not required (reference number E2-172) because this project should be considered as service evaluation and development.
The target of the core outcome set was to capture important outcomes for individual studies, systematic reviews, and guidelines for preterm birth prevention in asymptomatic woman. For our purposes, preterm birth was defined as neonates born alive before 37 weeks of gestation.5 (link) An asymptomatic woman was defined as one without symptoms of preterm labor (e.g increased uterine contractions, menstrual cramps of backache, color change of vaginal discharge, prelabor rupture of membranes). Preventive treatment of preterm birth was defined as one started before any symptoms of preterm labor were present. This preventive strategy could be pharmacologic (e.g. progesterone, marine oils, probiotics) or non-pharmacologic (e.g. cerclage, pessary, lifestyle interventions and alternative therapies).
A Project Steering Committee was established to give guidance to the different phases of this project consisting of two obstetricians (Irene de Graaf, Khalid S. Khan), two neonatologists (Timo de Haan, Stephen Kempley), two midwives (Felipe Castro, Birgit van der Goes), two patient representatives (Aoife Ahern, Mandy Daly) and three methodologists with experience in formal consensus and/or core outcome set methods (James Duffy, Brent Opmeer, and Paula Williamson).
A systematic literature review was undertaken searching the Cochrane Pregnancy and Childbirth Group's (PCG) Trials Register.1 The Pregnancy and Childbirth Group register is maintained by monthly searches of the Cochrane Central Register of Controlled Trials and weekly searches of EMBASE and MEDLINE and hand-searches of 30 journal and conference proceedings (from January 1997 to January 2011). The register was searched utilizing the register’s codes for preterm birth. Two reviewers (S.M. and Z.A.) independently screened titles and abstracts. They critically reviewed the full text of selected studies and extracted reported outcomes. Any discrepancies were resolved by discussion. In addition, all delegates (n=168) of the First European Spontaneous Preterm Birth Congress (Svendborg, Denmark, May 24–25, 2014), mainly representing obstetricians and researchers, but also midwives, neonatologists and members of industry, were requested via e-mail to recommend potential outcomes.
Patient representatives and parents were invited through social media (Twitter and patient forums on Facebook) to participate in an online questionnaire to share their opinions regarding outcomes relevant to preterm birth. Members of patient organisations including the European foundation for the Care of Newborn Infants, their partner organizations, and parental forums of neonatal baby units were e-mailed by their own organization including an invitation for the online questionnaire through an electronic newsletter. Patients also contributed their opinions through in-person semistructured interviews conducted by one of the authors (J.v.t.H.).
The Project Steering Committee identified outcomes that were duplicated as a result of varied terminologies used by different stakeholders and for grouping closely related outcomes into overarching domains. This outcome inventory of 29 outcomes was entered into a Delphi process (Figure 1).
We used a two-round electronic Delphi survey design, a well-established method to elicit consensus based on an iterative process with anonymous consultation and with controlled feedback and quantified analysis of the responses.6 A priori we agreed the important methodological features for our Delphi process: [1] composition of the group; [2] anonymity; [3] how to assess the importance of outcomes; [4] method of feedback of results to participants; [5] how consensus would be reached; [6] how to assess possible attrition bias.
The setting for the Delphi survey was multinational involving stakeholders from middle- and high-income countries. A formal written invitation was e-mailed to all members of the Cochrane Pregnancy and Childbirth group (n=30), the Core Outcomes in Women’s Health initiative (n=77), the European Preterm Birth Congress (n=168), and the Global Obstetrics Network (n=237). Most members of these organizations are researchers (methodologists), obstetricians (mainly specialized in maternal fetal medicine) or neonatologists. The European foundation for the Care of Newborn Infants approached their members themselves, including their partner organizations in Australia, Belgium, Bulgaria, Canada, Chile, Croatia, Cyprus, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Israel, Italy, Lithuania, Mexico, the Netherlands, Norway, Poland, Portugal, Spain, Turkey, United Kingdom, and the United States. All midwifes from ‘Barts Health Nursing and Midwifery’ (n=132) and some midwifes of the School of Nursing and Midwifery (Galway, Ireland) and the Dutch Consortium for Healthcare Evaluation in Obstetrics and Gynaecology were approached. With this approach we aimed to targeted midwifes who were active in research (50%) and midwifes who were not active in research (50%). In total 337 obstetricians, 152 midwives, 174 researchers, 75 neonatologists, and an unknown number of parents (through the previously mentioned patient organizations) were invited.
We used LimeSurvey for the Delphi survey. The survey was piloted first by eight people representing every stakeholder group. No changes were needed after the pilot. The official survey had a closing date of 5 weeks after the date of invitation for every Delphi round. An e-mail reminder was sent to participants on days 7, 14, 21, and 28. Nonresponders in the first round were not invited to participate in the subsequent round.
Participants were asked to rate the importance of each outcome on a 9-point Likert scale anchored between 1 (‘limited importance’) and 9 (‘critical importance’). The scale is recommended by the Grading of Recommendations Assessment, Development and Evaluation working group: 1–3: limited importance; 4–6: important but not critical; 7–9: critical.7 (link) Participants were invited to recommend additional potential outcomes for consideration at the end of the survey using free-text responses.
The individual, stakeholder group and total results from the first round were relayed back to participants by e-mail; the individual responses directly after filling in the first round questionnaire, the stakeholder group, and total group responses were fed back anonymously 1 day prior to the invitation to the second round of the Delphi survey. Furthermore, participants of the second survey were able to see the mean value of the total group responses from the first Delphi round while completing the survey. Participants were asked to score all the individual outcomes again using the same 9-point Likert scale. No outcomes were excluded in this round to ensure a holistic approach to scoring in round 2.
The Delphi survey responses were analyzed using SPSS version 21.0. For each outcome the median and interquartile range were calculated. Frequency tables of all scores were generated, as well as boxplots for visualization (that were used to relay back the whole and stakeholder group responses). We defined consensus a priori. Core outcomes required at least 70% of participants in each stakeholder group scoring the outcome as ‘critical’ and less than 15% of participants in each stakeholder group scoring the outcome as ‘limited importance’.8 (link) Outcomes which should not be included in a core outcome set required at least 70% of participants in each stakeholder group scoring the outcome as ‘limited importance’ and less than 15% of participants in each stakeholder group scoring the outcome as ‘critical’. If outcomes did not meet either criteria they were classified as outcomes with no consensus. Attrition bias (e.g. a selective group did not respond to the second round of the survey or a selective group participated in the consultation meeting) was assessed by 1) comparing the distribution of median first round scores across the outcomes for those not participating in the second round with those who did; and 2) comparing the distribution of median round 2 scores across the outcomes for those participating in the consultation meeting compared with those who did not.
The final phase of the study was a face-to-face consultation meeting with participants of the Delphi exercise representing all stakeholder groups (Washington, DC, November 9, 2014). This meeting was organized within a meeting for a prospective individual participant data analysis project for studies on the use of pessary in the prevention of preterm birth in asymptomatic women. Eleven participants of this prospective individual patient data project did also took part in the Delphi survey earlier. They mainly represented the stakeholder groups of obstetricians and methodologists. Representatives from the other stakeholder groups (parents, midwives and neonatologists), who were living close to the location of the consultation meeting, were invited for this consultation meeting as well. In total 23 obstetricians, 10 researchers, two neonatologists, two patient representatives, and one midwife were invited to attend this meeting. Information material on the purpose of the consultation meeting and the Delphi round 2 results were sent to participants before the meeting. A plenary presentation on the Delphi survey outcomes was complemented by small group sessions (mixed groups) where participants expressed their views on the candidate outcomes. Only outcomes that did not reach full consensus in the Delphi exercise were presented to the attendees of the meeting with an anonymous voting using electronic touchpads. Consensus in the consultation meeting required a majority of 70% of participants from each stakeholder group approving an individual outcome as ‘critical’ according to the 1–9 Likert scale. With the permission of the participants the consultation meeting was recorded.
Publication 2016
Alternative Therapies Back Pain Childbirth Comet Assay Dysmenorrhea Europeans Face Fetal Membranes, Premature Rupture Genetic Code Infant Infant, Newborn Marines Midwife Neonatologists Obstetrician Oils Parent Patient Representatives Patients Pessaries Pregnancy Premature Birth Premature Obstetric Labor Probiotics Progesterone Tooth Attrition Uterine Contraction Woman
The manual segmentation of the NeoBrainS12 images was carried out using T2-weighted images and in-house software, “either by MDs who were working toward a PhD in neonatology, or by trained medical students. The segmentations were verified independently by three neonatologists with each at least seven years of experience in reading neonatal MRI scans” (Isgum et al., 2015 (link)). Details of the manual segmentation protocol are available at http://neobrains12.isi.uu.nl/reference.php and in the NeoBrainS12 publication (Isgum et al., 2015 (link)). Eight tissue classes were manually delineated; the cortical gray matter (including hippocampus and amygdala), myelinated white matter, unmyelinated white matter, deep nuclear gray matter (i.e., basal ganglia and thalami), brainstem, cerebellum, CSF in the ventricles and CSF in the extracerebral space. For the purpose of comparison with the MANTiS segmentation, myelinated and unmyelinated white matter classes were combined, and the two CSF classes were combined.
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Publication 2016
Amygdaloid Body Basal Ganglia Brain Stem Cerebellum Cortex, Cerebral Gray Matter Heart Ventricle Infant, Newborn MRI Scans Neonatologists Seahorses Students, Medical Thalamus Tissues White Matter
Liveborn infants enrolled in the Generic Database registry of the NICHD Neonatal Research Network were eligible for inclusion in the study if they met the following three criteria: they were born between January 1, 2000, and December 31, 2011, their gestational age at birth was 22 0/7 to 28 6/7 weeks, and they were born in a Neonatal Research Network center. The inclusion criteria were chosen to ensure a consistent selection of infants throughout the study period, because the registry selection criteria were revised in 2008 to exclude infants not born in Neonatal Research Network centers and those with a gestational age at birth of 29 weeks or older. The registry was reviewed and approved by the institutional review board at each participating center. In 3 centers, written or oral informed consent was obtained from the parent or guardian, and in the other 22 centers, a waiver of the requirement for consent was approved by the institutional review board.
Data were collected prospectively by trained research coordinators for all liveborn infants, including those never admitted to an intensive care unit. Gestational age was determined with the use of the best obstetrical estimate based on the date of the last menstrual period, obstetrical variables, prenatal ultrasonography, or all three. If the best obstetrical estimate was unavailable or uncertain, gestational age was determined on the basis of the neonatologist’s estimate with the use of physical examination criteria, including the Ballard9 (link) or Dubowitz10 (link) examination. Enrolled infants were actively followed from birth to a postnatal age of 120 days, death, hospital discharge, or transfer to another center (whichever occurred first); infants who remained hospitalized for more than 120 days were evaluated for death until 1 year of age. The primary cause of death was prospectively identified and defined as the single underlying, proximate disease that initiated the series of events leading to the final cause of death. The definitions of the specific causes of death are listed in Table S1 in the Supplementary Appendix (available with the full text of this article at NEJM.org) and were included in the manual of operations for the registry. The primary cause of death had to be causally specific to the underlying disease and antecedent to all other causes with respect to time and pathologic relationship. Primary causes of death with infection or central nervous system (CNS) injury as complicating factors were identified from prespecified subcauses. If autopsy findings were available, the cause of death was based on both clinical and autopsy findings. In situations in which the cause of death was not certain, the single cause of death was selected after consultation with the principal investigator (or appointee) from each center. However, interobserver reliability was not assessed. Causes of death that could not be classified as one of the prespecified causes were classified as “other.” Causes that were investigated but could not be established were classified as “unknown.”
Publication 2015
Autopsy Birth Childbirth Ethics Committees, Research Generic Drugs Gestational Age Infant Infant, Newborn Infection Legal Guardians Menstruation Neonatologists Parent Patient Discharge Physical Examination Trauma, Nervous System Ultrasonography, Prenatal
Three lead authors, one neonatologist (YS), one paediatric intensivist (DDL) and one paediatric cardiologist (CT), identified expert colleagues who significantly contributed with publications in the POCUS field and/or have developed POCUS training courses in the last 10 years, similarly to what had been done with previous ESPNIC guidelines [12 (link)]. Panellists selection was performed prior to the literature search and for logistic reasons, the number of participants was limited to a maximum of 20. These colleagues should have been fairly representative of all POCUS fields and both Europe and North America and include also non-ESPNIC members. Moreover, at least one co-author should have been an expert in guidelines development and supervised the whole methodology, while literature search was performed by each panellist for their sub-section. All invited experts agreed to participate. Details of the methods used to produce these guidelines are given in the additional file for online supplementary material (see Additional file 1). These guidelines followed relevant ESPNIC internal procedures for manuscript endorsement, and this included an external review by ESPNIC officers not included among the panellists. Guidelines have been prepared according to the international Appraisal of Guidelines, Research and Evaluation (AGREE) [13 (link)]. Each recommendation is intended to be applied both for paediatric and neonatal patients, unless otherwise specified.
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Publication 2020
Cardiologists Infant, Newborn Neonatologists Patients

Most recents protocols related to «Neonatologists»

Two pairs in the research team (one neonatologist and one paediatrician in the first pair, one paediatrician and one general physician in the other pair) analysed the relevance of the identified problems and actions taken based on facilitators’ diaries from the 52 facilities. The independent scoring of each analyst was discussed to reach a consensus. A maximum score of 22 points could be obtained in the knowledge assessment (1 point for each correctly answered question). Baseline and endline results were compared across levels of the health systems (commune health centres and hospitals) and categories of health workers (physician, midwife and nurse). Data from the antenatal care observations were compared before and after the 12 months of PeriKIP intervention. Data from knowledge assessment and observations were entered using EpiData (version 3.1) and analysed in SAS (version 9.4). Descriptive statistics included proportions, means with 95% confidence intervals and t-tests with p-values.
The qualitative data were transcribed verbatim, translated into English and analysed by content analysis with both inductive and deductive features [45 (link)]. First, each interview of each type (midwives, village health workers, PeriKIP groups at hospitals, facilitators) was read several times to get a naïve understanding. This step informed the decision to approach the material as one data set. After that, open coding was undertaken. Codes were written in the margin of each interview describing aspects of the content. Codes were sorted into sub-categories; thereafter, sub-categories were sorted under categories, and finally, categories were placed under four main categories, i.e. the i-PARIHS dimensions (Innovation, Recipients, Facilitation and Context). One relevant category, Gaining knowledge and insights, as identified in the qualitative analysis, could not be sorted under the i-PARIHS dimensions. This category is presented together with the study outcomes.
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Publication 2023
Care, Prenatal General Practitioners Health Personnel Midwife Neonatologists Nurses Pediatricians Physicians Village Health Workers
The control group parents received the standard perinatal care offered by the hospitals they were recruited from, which consisted of antenatal checkups, optional antenatal classes, care during their stay in the ward, and a postnatal review scheduled 6 weeks post partum. Perinatal care was provided to the parents by obstetricians, nurses, neonatologists, and lactation consultants. The intervention group parents received the standard perinatal care as well, but they were also granted access to the mHealth intervention SPA upon recruitment into the study. In addition, they were matched with trained peer volunteers, who were experienced mothers trained by the research team to provide peer support for the parents in the RCT.
SPA included a variety of pregnancy-, childbirth-, postpartum-, and infant care–related information. This included articles, audio files, and videos about birth preparation, bonding and attachment across the perinatal period, breastfeeding, baby care–related tasks (from bathing to safe sleep habits), and involvement of both fathers and mothers in baby care tasks. The information was curated by the health care professionals involved in the study so that parents could conveniently access reliable and accurate information. Expert advice, discussion forums, and frequently asked questions were also features of the mobile app that aimed to resolve any pregnancy- or childcare-related queries that the parents might have. The parents were encouraged to interact with the peer volunteer with whom they were matched if they needed emotional or informational support from experienced mothers who had previously had and recovered from postnatal depression. Detailed features of the SPA mobile app and peer volunteer intervention can be found in the published development study [26 (link)]. The SPA intervention was made available to the intervention group parents from the point of recruitment until 6 months post partum.
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Publication 2023
Childbirth Depression, Postpartum Emotions Fathers Health Care Professionals Mobile Health Mothers Neonatologists Nurses Obstetric Delivery Obstetrician Parent Perinatal Care Pregnancy Voluntary Workers
The inclusion criteria for participation in the study were (1) being a neonatologist currently working in a Greek NICU and (2) having worked in a Greek NICU for at least one year prior to the interview. The exclusion criterion for participation in the study was the inability to communicate effectively in the Greek language.
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Publication 2023
Neonatologists
The present work was a prospective qualitative research study based on in-depth interviews conducted with neonatologists who had worked in Greek neonatal intensive care units (NICUs) for at least one year prior to the interview. This qualitative descriptive study was conducted from March 2022 to August 2022. Thematic analysis was selected as the methodological orientation of the study.
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Publication 2023
Neonatologists
An interview guide was developed based on a review of the relevant literature [1 –3 (link), 6 (link)–10 (link), 13 (link), 15 (link)–18 (link)]. To obtain a deep and comprehensive understanding of the concepts under investigation (neonatologists’ moral distress), the interviews covered a number of topics intended to capture a wide range of the participants’ lived experiences. Below, we specify a few questions that were included in the interview guide:

1) If you have ever face the question of whether the treatment you provided or recommended was the right one, how did you respond to these situations? Why did you respond as you did?

2) Please describe to me in detail any significant difficulties you encountered in making a clear judgement regarding what course of action should be taken.

a) Please describe to me in detail real past case(s) (if any) in which you felt constrained from acting on what you knew to be right. Please describe to me in detail your related experiences.

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Publication 2023
Face Feelings Neonatologists

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