Long-term outcomes: what should the focus be?
The neonatal intervention trials of the 1980s and early 1990s focused primarily on short-term outcomes. Contemporary clinical trials have recognized the importance of longer-term outcomes but have rarely been powered to achieve that aim. This review discusses important and clinically relevant outcomes that future trials should be powered to address and identifies the challenges facing the neonatal clinical trials community. These challenges include consensus definitions of relevant outcomes that are objective and validated, variability among centers in populations and practices, and the need for predictive surrogate markers of long-term outcomes. Future trials must be designed and powered to address the potential for harm as well as the prospect of benefit.
Aschner
Judy L
JL
Department of Pediatrics and The Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN 37232-9544, USA. judy.aschner@vanderbilt.edu
Walsh
Michele C
MC
D001997:Bronchopulmonary Dysplasia / Q000145:classification / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000379:methods*; D017063:Outcome Assessment, Health Care; D011663:Pulmonary Surfactants / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy / Q000517:prevention & control
D011663:Pulmonary Surfactants