Research priorities and potential methodologies to inform care in subsequent pregnancies following stillbirth: a web-based survey of healthcare professionals, researchers, and advocatesCitation formats

  • External authors:
  • Aleena M. Wojcieszek
  • Philippa Middleton
  • David Ellwood
  • Robert M. Silver
  • Vicki Flenady

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Research priorities and potential methodologies to inform care in subsequent pregnancies following stillbirth: a web-based survey of healthcare professionals, researchers, and advocates. / Wojcieszek, Aleena M.; Heazell, Alexander; Middleton, Philippa; Ellwood, David; Silver, Robert M.; Flenady, Vicki.

In: BMJ Open, 04.06.2019.

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@article{7156c383db0943d8bfaf3fd3823c4fc3,
title = "Research priorities and potential methodologies to inform care in subsequent pregnancies following stillbirth: a web-based survey of healthcare professionals, researchers, and advocates",
abstract = "Objectives: To identify research priorities and explore potential methodologies to inform care in subsequent pregnancies following a stillbirth.Design: Web-based survey by invitation.Participants: Multidisciplinary panel of 79 individuals involved in stillbirth research, clinical practice, and/or advocacy from the international stillbirth research community (response rate = 64{\%}).Outcome measures: Importance of 16 candidate research topics, and perceived utility and appropriateness of randomised controlled trial (RCT) methodology for the evaluation of four pertinent interventions: (1) medical therapies for placental dysfunction (e.g. antiplatelet agents); (2) additional antepartum fetal surveillance (e.g. ultrasound scans); (3) early planned birth from 37 weeks’ gestation; and (4) different forms of psychosocial support for parents and families.Results: Candidate research topics that were rated as ‘Important and urgent’ by the greatest proportion of participants were: medical therapies for placental dysfunction (81{\%}); additional antepartum fetal surveillance (80{\%}); the development of a core outcomes dataset for stillbirth research (79{\%}); targeted antenatal interventions for women who have risk factors (79{\%}); and calculating the risk of recurrent stillbirth according to specific causes of index stillbirth (79{\%}). Whether RCT methodologies were considered appropriate for the four selected interventions varied depending on the criterion being assessed. For example, while 72{\%} of respondents felt that RCTs were ‘the best way’ to evaluate medical therapies for placental dysfunction, fewer respondents (63{\%}) deemed RCTs ethical in this context, and approximately only half (52{\%}) felt that such RCTs were feasible. There was considerably less support for RCT methodology for the evaluation of different forms of psychosocial support, which was reinforced by free-text comments.Conclusions: Five priority research topics to inform care in pregnancies after stillbirth were identified. There was support for RCTs in this area, but the panel remained divided on the ethics and feasibility of such trials. Engagement with parents and families is a critical next step",
keywords = "stillbirth, subsequent pregnancy, priority setting, implementation, RCTs",
author = "Wojcieszek, {Aleena M.} and Alexander Heazell and Philippa Middleton and David Ellwood and Silver, {Robert M.} and Vicki Flenady",
year = "2019",
month = "6",
day = "4",
language = "English",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "B M J Group",

}

RIS

TY - JOUR

T1 - Research priorities and potential methodologies to inform care in subsequent pregnancies following stillbirth: a web-based survey of healthcare professionals, researchers, and advocates

AU - Wojcieszek, Aleena M.

AU - Heazell, Alexander

AU - Middleton, Philippa

AU - Ellwood, David

AU - Silver, Robert M.

AU - Flenady, Vicki

PY - 2019/6/4

Y1 - 2019/6/4

N2 - Objectives: To identify research priorities and explore potential methodologies to inform care in subsequent pregnancies following a stillbirth.Design: Web-based survey by invitation.Participants: Multidisciplinary panel of 79 individuals involved in stillbirth research, clinical practice, and/or advocacy from the international stillbirth research community (response rate = 64%).Outcome measures: Importance of 16 candidate research topics, and perceived utility and appropriateness of randomised controlled trial (RCT) methodology for the evaluation of four pertinent interventions: (1) medical therapies for placental dysfunction (e.g. antiplatelet agents); (2) additional antepartum fetal surveillance (e.g. ultrasound scans); (3) early planned birth from 37 weeks’ gestation; and (4) different forms of psychosocial support for parents and families.Results: Candidate research topics that were rated as ‘Important and urgent’ by the greatest proportion of participants were: medical therapies for placental dysfunction (81%); additional antepartum fetal surveillance (80%); the development of a core outcomes dataset for stillbirth research (79%); targeted antenatal interventions for women who have risk factors (79%); and calculating the risk of recurrent stillbirth according to specific causes of index stillbirth (79%). Whether RCT methodologies were considered appropriate for the four selected interventions varied depending on the criterion being assessed. For example, while 72% of respondents felt that RCTs were ‘the best way’ to evaluate medical therapies for placental dysfunction, fewer respondents (63%) deemed RCTs ethical in this context, and approximately only half (52%) felt that such RCTs were feasible. There was considerably less support for RCT methodology for the evaluation of different forms of psychosocial support, which was reinforced by free-text comments.Conclusions: Five priority research topics to inform care in pregnancies after stillbirth were identified. There was support for RCTs in this area, but the panel remained divided on the ethics and feasibility of such trials. Engagement with parents and families is a critical next step

AB - Objectives: To identify research priorities and explore potential methodologies to inform care in subsequent pregnancies following a stillbirth.Design: Web-based survey by invitation.Participants: Multidisciplinary panel of 79 individuals involved in stillbirth research, clinical practice, and/or advocacy from the international stillbirth research community (response rate = 64%).Outcome measures: Importance of 16 candidate research topics, and perceived utility and appropriateness of randomised controlled trial (RCT) methodology for the evaluation of four pertinent interventions: (1) medical therapies for placental dysfunction (e.g. antiplatelet agents); (2) additional antepartum fetal surveillance (e.g. ultrasound scans); (3) early planned birth from 37 weeks’ gestation; and (4) different forms of psychosocial support for parents and families.Results: Candidate research topics that were rated as ‘Important and urgent’ by the greatest proportion of participants were: medical therapies for placental dysfunction (81%); additional antepartum fetal surveillance (80%); the development of a core outcomes dataset for stillbirth research (79%); targeted antenatal interventions for women who have risk factors (79%); and calculating the risk of recurrent stillbirth according to specific causes of index stillbirth (79%). Whether RCT methodologies were considered appropriate for the four selected interventions varied depending on the criterion being assessed. For example, while 72% of respondents felt that RCTs were ‘the best way’ to evaluate medical therapies for placental dysfunction, fewer respondents (63%) deemed RCTs ethical in this context, and approximately only half (52%) felt that such RCTs were feasible. There was considerably less support for RCT methodology for the evaluation of different forms of psychosocial support, which was reinforced by free-text comments.Conclusions: Five priority research topics to inform care in pregnancies after stillbirth were identified. There was support for RCTs in this area, but the panel remained divided on the ethics and feasibility of such trials. Engagement with parents and families is a critical next step

KW - stillbirth

KW - subsequent pregnancy

KW - priority setting

KW - implementation

KW - RCTs

M3 - Article

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

ER -