Prioritization

Cochrane Neonatal's prioritization process      

Background

Cochrane Neonatal  aims to create and disseminate systematic reviews of the evidence in newborn care. These resources help our community of clinicians, patients, policymakers, and guideline developers provide the best possible evidence-based care for infants and families around the world.

Our reviews are produced with support from Vermont Oxford Network, a worldwide collaboration of health professionals dedicated to providing evidence-based care of the highest quality for newborn infants and their families.

We publicize and disseminate our reviews, and the work of Cochrane, through our web seminars (these seminars are funded through an American Academy of Pediatrics (AAP) Neonatal-Perinatal Medicine Strategic Plan Grant, and by our partners at Vermont Oxford Network); and by promotion of blogshots on Twitter. Our full-text Cochrane Neonatal Reviews, are available via the Cochrane at VON website.

Our prioritization process follows the Cochrane Guidance for priority setting document; and is  in line with the Cochrane Children and Families Network Strategic Plan.

Governance

The Cochrane Neonatal’s steering group, the Editorial Board, uses multiple inputs and approaches to  decide which clinically important research topics to focus on and prioritize.

The Editorial Board (which consists of our Editorial Team, Senior Editors and Associate Editors), meets in person annually (most recently in April 2019) and meets via web conference bi-annually (most recently in November 2020).

Prioritization Process

We consider editorial priorities during our editorial meetings. We discuss the relevance of topics to parents and other healthcare decision makers, and also the likely impact a review topic will attract. Over 100 of Cochrane Neonatal Reviews have, for example, been used to create over 80 international guidelines for best practice.

Once every three years we conduct a Delphi process amongst our extended team of Senior Editors and Associate Editors, and Peer Reviewers in order to prioritize reviews for updating. With over 400 published Cochrane Neonatal reviews, prioritizing updates is a pressing issue. Most recently, we conducted the prioritization process in two steps beginning in May 2018.

For this process, we considered all of our reviews which had not published within the last two years (up to April 2018). Then we ordered these reviews based upon their usage (as determined by citation reports, using Google Scholar. We circulated the titles of the top 50 reviews to our team of experts and asked them to rank the top 10 reviews for updating based upon clinical need and the availability of potential new research.

Stakeholder engagement 

In June 2019, we conducted the second stage of the prioritization process. We invited members of the neonatal community including caregivers, researchers, and families who are on our mailing list (over 5000), to participate in the Delphi process in conjunction with our Editorial Board. The survey included the list of the same 50 reviews presented to the editors. Stakeholders were asked to choose 10 of the reviews which they believed were the highest priority for updating, with a prompt to consider: (1) availability of new research to be incorporated into the review, (2) clinical importance, (3) current uncertainty or variation in clinical practice.

Of the 46 respondents, 100% provided complete responses. Data for individual respondents was not collected, but the mailing list consists of members for around the globe, including countries from a variety of regions (Asia and Pacific, Europe, the Americas, and Africa).

We collated the responses and incorporated them into the priority list, with the community choosing two additional reviews beyond the 10 identified by the editorial board. 

Continued stakeholder engagement 

We actively encourage caregivers and parents in the neonatal community to provide input for our work. We always welcome input. If you are a parent, family member, or caregiver of a neonate, please take our Consumer Engagement Survey. Your valuable input will help us improve the accessibility of our reviews.

Documentation and dissemination

Cochrane Neonatal's priority-setting process is documented above.

Additionally, we prioritize new reviews and review updates as new research arises. We also prioritize reviews when they have been requested by guideline development groups.

The list of priority reviews are published below.

For full-text Cochrane Neonatal Reviews, visit the Cochrane at VON website

Timeline

We will conduct the next prioritization exercise in 2021. In the next round, will add some of the following processes: (1) disseminate the prioritization call for engagement more broadly to include other Cochrane groups and additional external stakeholders, and (2) we will include the findings of other recently published prioritization exercises in neonatal medicine, as was conducted by Oliver, et al. 2019, in conjunction with the James Lind Alliance.1

Priority Reviews

New Reviews

  • Lipid emulsions for parenterally fed preterm infants* - Published June 2019     
  • Lipid emulsions for parenterally fed term and late preterm infants* - Published June 2019
  • Network meta-analysis of corticosteroids for the prevention and treatment of bronchopulmonary dysplasia*  
  • Nutrient-enriched formula versus standard formula for preterm infants* -  Published August 2019

 Updated Reviews

  • Air versus oxygen for resuscitation of infants at birth  
  • Anticonvulsants for neonates with seizures (replaced by Anti-epileptic therapy to reduce mortality and neuro-developmental disability in neonates with seizures)  
  • Banked preterm versus banked term human milk to promote growth and development in very low birth weight infants* - Published June 2019 
  • Cooling for newborns with hypoxic ischaemic encephalopathy
  • Devices and pressure sources for administration of nasal continuous positive airway pressure 
  • Developmental care for promoting development and preventing morbidity in preterm infants 
  • Dilute versus full strength formula in exclusively formula-fed preterm or low birth weight infants* - Published June 2019 
  • Elective high frequency oscillatory ventilation versus conventional ventilation for acute pulmonary dysfunction in preterm infants  
  • Formula milk versus maternal breast milk for feeding preterm or low birth weight infants* - Published July 2019 
  • Formula versus donor breast milk for feeding preterm or low birth weight infants* - Published July 2019 
  • Ibuprofen for the prevention of patent ductus arteriosus in preterm and/or low birth weight infants - Published June 2019
  • Nasal continuous positive airway pressure immediately after extubation for preventing morbidity in preterm infants  
  • Nasal high flow therapy for primary respiratory support in preterm infants (formerly named: High flow nasal cannula for respiratory support in preterm infants) 
  • Protein hydrolysate versus standard formula for preterm infants* - Published July 2019  
  • Prophylactic vitamin K for vitamin K deficiency bleeding in neonates 
  • Probiotics to prevent necrotising enterocolitis in very preterm or very low birth weight infants – Published October 2020 
  • Prophylactic versus selective use of surfactant in preventing morbidity and mortality in preterm infants 
  • Prophylactic intravenous indomethacin for preventing mortality and morbidity in preterm infants  

*Funded reviews

1 Oliver S, Uhm S, Duley L, Crowe S, David AL, James CP, Chivers Z, Gyte G, Gale C, Turner M, Chambers B, Dowling I, McNeill J, Alderdice F, Shennan A, Deshpande S. Top research priorities for preterm birth: results of a prioritisation partnership between people affected by preterm birth and healthcare professionals. BMC Pregnancy Childbirth. 2019 Dec 30;19(1):528. doi: 10.1186/s12884-019-2654-3. PMID: 31888523; PMCID: PMC6938013.