Does crossover treatment of control subjects invalidate results of randomized trials of patent ductus arteriosus treatment?

Optimal management of patent ductus arteriosus (PDA) in extremely preterm infants remains controversial. There is paucity of evidence on the benefits of PDA treatment in reducing mortality and morbidities in extremely preterm infants. Failure of randomized clinical trials to demonstrate beneficial e...

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Publicado en:Journal of Perinatology Vol. 40; no. 12; pp. 1863 - 1871
Autores principales: Sankar, Meera N., Benitz, William E.
Formato: tables/charts Journal Article
Publicado: Springer Nature Dec2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2020
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      pub: Springer Nature
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        10.1038/s41372-020-00848-z
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        atl: Does crossover treatment of control subjects invalidate results of randomized trials of patent ductus arteriosus treatment?
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        au:
          Sankar, Meera N.
          Benitz, William E.
        affil: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
      sug:
        subj:
          Ductus Arteriosus, Patent Therapy
          Randomized Controlled Trials
          Research Subjects
          Treatment Outcomes
          Morbidity
          Infant, Premature
          Infant, Newborn
          Age Factors
          Research Subject Recruitment
          Infant, Newborn: birth-1 month
      ab: Optimal management of patent ductus arteriosus (PDA) in extremely preterm infants remains controversial. There is paucity of evidence on the benefits of PDA treatment in reducing mortality and morbidities in extremely preterm infants. Failure of randomized clinical trials to demonstrate beneficial effects of PDA treatment on outcomes has often been attributed to open treatment of control subjects. This perspective examines the PDA treatment trials to date, with specific focus on rates of and ages of subjects at open rescue treatment. Although these trials demonstrate that ductal closure is significantly increased with treatment, that does not translate to a significant decrease in major morbidities or mortality in premature infants, even when trials with high rates of rescue treatment of controls are excluded. Trials in which enrollment occurred after 7 days of age include insufficient numbers of subjects to evaluate this relationship.
      pubtype: Academic Journal
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        Journal Article
      ougenre: Article
    language: English
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