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Rosala-Hallas A, Jones AP, Williamson PR, Bedson E, Compton V, Fernandes RM, Lacy D, Lyttle MD, Peak M, Thorburn K, Woolfall K, Van Miert C, McNamara PS. Which outcomes should be used in future bronchiolitis trials? Developing a bronchiolitis core outcome set using a systematic review, Delphi survey and a consensus workshop. BMJ Open 2022; 12:e052943. [PMID: 35264343 PMCID: PMC8915376 DOI: 10.1136/bmjopen-2021-052943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The objective of this study was to develop a core outcome set (COS) for use in future clinical trials in bronchiolitis. We wanted to find out which outcomes are important to healthcare professionals (HCPs) and to parents and which outcomes should be prioritised for use in future clinical trials. DESIGN AND SETTING The study used a systematic review, workshops and interviews, a Delphi survey and a final consensus workshop. RESULTS Thirteen parents and 45 HCPs took part in 5 workshops; 15 other parents were also separately interviewed. Fifty-six items were identified from the systematic review, workshops and interviews. Rounds one and two of the Delphi survey involved 299 and 194 participants, respectively. Sixteen outcomes met the criteria for inclusion within the COS. The consensus meeting was attended by 10 participants, with representation from all three stakeholder groups. Nine outcomes were added, totalling 25 outcomes to be included in the COS. CONCLUSION We have developed the first parent and HCP consensus on a COS for bronchiolitis in a hospital setting. The use of this COS will ensure outcomes in future bronchiolitis trials are important and relevant, and will enable the trial results to be compared and combined. TRIAL REGISTRATION NUMBER ISRCTN75766048.
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Affiliation(s)
- A Rosala-Hallas
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, Merseyside, UK
| | - Ashley P Jones
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, Merseyside, UK
| | - Paula R Williamson
- Health Data Science, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Emma Bedson
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, Merseyside, UK
| | - Vanessa Compton
- Paediatric Intensive Care Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, Merseyside, UK
| | - Ricardo M Fernandes
- Department of Pediatrics, Santa Maria Hospital, Lisbon Academic Medical Centre, Lisbon, Portugal
- Clinical Pharmacology and Therapeutics, Faculty of Medicine, Instituto de Medicina Molecular, Universidade de Lisboa, Lisboa, Portugal
| | - David Lacy
- Department of Paediatrics, Wirral University Teaching Hospital NHS Foundation Trust, Wirral, Merseyside, UK
| | - Mark David Lyttle
- Emergency Department, Bristol Royal Hospital for Children, Bristol, UK
- Faculty of Health and Applied Science, University of the West of England, Bristol, UK
| | - Matthew Peak
- Clinical Research Division, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Kentigern Thorburn
- Paediatric Intensive Care Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, Merseyside, UK
| | - Kerry Woolfall
- Institute of Population, Health and Society, University of Liverpool, Liverpool, Merseyside, UK
| | - Clare Van Miert
- School of Nursing and Allied Health, Liverpool John Moores University, Liverpool, Merseyside, UK
| | - Paul S McNamara
- Department of Child Health (University of Liverpool), Institute in the Park, Alder Hey Children's Hospital, Liverpool, Merseyside, UK
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Irvine A, Jones A, Beattie P, Baron S, Browne F, Ashoor F, O'Neill L, Rosala-Hallas A, Sach T, Spowart C, Taams L, Walker C, Wan M, Webb N, Williamson P, Flohr C. The TREatment of severe Atopic eczema Trial (TREAT). Br J Dermatol 2018. [DOI: 10.1111/bjd.17052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Irvine AD, Jones AP, Beattie P, Baron S, Browne F, Ashoor F, O'Neill L, Rosala-Hallas A, Sach T, Spowart C, Taams L, Walker C, Wan M, Webb N, Williamson P, Flohr C. A randomized controlled trial protocol assessing the effectiveness, safety and cost-effectiveness of methotrexate vs. ciclosporin in the treatment of severe atopic eczema in children: the TREatment of severe Atopic eczema Trial (TREAT). Br J Dermatol 2018; 179:1297-1306. [PMID: 29727479 DOI: 10.1111/bjd.16717] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Oral systemic immunomodulatory medication is regularly used off-licence in children with severe atopic eczema. However, there is no firm evidence regarding the effectiveness, safety, cost-effectiveness and impact on quality of life from an adequately powered randomized controlled trial (RCT) using systemic medication in children. OBJECTIVES To assess whether there is a difference in the speed of onset, effectiveness, side-effect profile and reduction in flares post-treatment between ciclosporin (CyA) and methotrexate (MTX), and also the cost-effectiveness of the drugs. Treatment impact on quality of life will also be examined in addition to whether FLG genotype influences treatment response. In addition, the trial studies the immune-metabolic effects of CyA and MTX. METHODS Multicentre, parallel group, assessor-blind, pragmatic RCT of 36 weeks' duration with a 24-week follow-up period. In total, 102 children aged 2-16 years with moderate-to-severe atopic eczema, unresponsive to topical treatment will be randomized (1 : 1) to receive MTX (0·4 mg kg-1 per week) or CyA (4 mg kg-1 per day). RESULTS The trial has two primary outcomes: change from baseline to 12 weeks in Objective Severity Scoring of Atopic Dermatitis (o-SCORAD) and time to first significant flare following treatment cessation. CONCLUSIONS This trial addresses important therapeutic questions, highlighted in systematic reviews and treatment guidelines for atopic eczema. The trial design is pragmatic to reflect current clinical practice.
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Affiliation(s)
- A D Irvine
- Clinical Medicine, Trinity College Dublin, Dublin, Ireland.,Paediatric Dermatology, Our Lady's Children Hospital Crumlin, Dublin, Ireland.,National Children's Research Centre, Crumlin, Dublin, Ireland
| | - A P Jones
- Clinical Trials Research Centre, Department of Biostatistics, University of Liverpool, Liverpool, U.K
| | - P Beattie
- Royal Hospital for Children NHS Trust, Glasgow, U.K
| | - S Baron
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
| | - F Browne
- Paediatric Dermatology, Our Lady's Children Hospital Crumlin, Dublin, Ireland
| | - F Ashoor
- Clinical Trials Research Centre, Department of Biostatistics, University of Liverpool, Liverpool, U.K
| | - L O'Neill
- Biochemistry, Trinity College Dublin, Dublin, Ireland
| | - A Rosala-Hallas
- Clinical Trials Research Centre, Department of Biostatistics, University of Liverpool, Liverpool, U.K
| | - T Sach
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, U.K
| | - C Spowart
- Clinical Trials Research Centre, Department of Biostatistics, University of Liverpool, Liverpool, U.K
| | - L Taams
- Centre for Molecular and Cellular Biology of Inflammation, King's College London, London, U.K
| | - C Walker
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
| | - M Wan
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
| | - N Webb
- Renal Research Laboratories, Manchester Royal Infirmary, Manchester, U.K
| | - P Williamson
- Clinical Trials Research Centre, Department of Biostatistics, University of Liverpool, Liverpool, U.K
| | - C Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
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- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
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