title: A critical question for NEC researchers: Can we create a consensus definition of NEC that facilitates research progress?
abstract: In the last decades the reported incidence of preterm necrotizing enterocolitis (NEC) has been declining in large part due to implementing comprehensive NEC prevention initiatives, including breast milk feeding, standardized feeding protocols, transfusion guidelines, and antibiotic stewardship and improving the rigor with which non-NEC cases are excluded from NEC data. However, after more than 60 years of NEC research in animal models, the promise of a "magic bullet" to prevent NEC has yet to materialize. There are also serious issues involving clinical NEC research. There is a lack of a common, comprehensive definition of NEC. National datasets have their own unique definition and staging definitions. Even within academia, randomized trials and single center studies have widely disparate definitions. This makes NEC metadata of very limited value. The world of neonatology needs a comprehensive, universal, consensus definition of NEC. It also needs a de-identified, international data warehouse.
authors.affiliation: Department of Pediatrics, Sacred Heart Children's Hospital, Pensacola, FL.
authors.forename: Phillip V
authors.initials: PV
authors.lastname: Gordon
authors.affiliation: Department of Pediatrics, University of Virginia Children's Hospital, Box 800386, Charlottesville, VA 22908. Electronic address: jrs3yc@virginia.edu.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Swanson
authors.affiliation: Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Brianna C
authors.initials: BC
authors.lastname: MacQueen
authors.affiliation: Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Christensen
mesh_terms: D000818:Animals; D035843:Biomedical Research / Q000639:trends*; D032921:Consensus; D066264:Datasets as Topic; D020345:Enterocolitis, Necrotizing / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D019317:Evidence-Based Medicine; D006801:Humans; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D009359:Neonatology / Q000639:trends*; D011322:Primary Prevention / Q000379:methods / Q000639:trends; D016032:Randomized Controlled Trials as Topic; D012108:Research Personnel
keywords: Diagnosis; Gestational age; Necrotizing enterocolitis; Pneumatosis; Thrombocytopenia