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Methods of identifying surgical necrotizing enterocolitis – a systematic review and meta-analysis

Methods of identifying surgical necrotizing enterocolitis – a systematic review and meta-analysis
Methods of identifying surgical necrotizing enterocolitis – a systematic review and meta-analysis
Background: current data suggests potential benefit of earlier surgery for necrotising enterocolitis (NEC) however this requires accurate prognostication early in the disease course. This study aims to identify and determine the effectiveness of previously reported methods or tests for the identification of surgical NEC.

Methods: systematic review and meta-analysis with registration on PROSPERO including articles describing a method of identifying surgical NEC. Outcomes of interest were effectiveness and repeatability of index test.

Results: of the 190 full-text articles screened, 90 studies were included which contained 114 methods of identifying surgical NEC in 9546 infants. Of these methods, 44 were a scoring system, 37 a single biomarker, 24 an imaging method and 9 an invasive method. Sensitivity and specificity ranged from 12.8-100% and 13-100%, respectively. Some methods (9.6%) provided insufficient methods for repeatability within clinical practice or research. Meta-analyses were possible for only 2 methods, the metabolic derangement 7 score and abdominal ultrasound.

Conclusions: a range of methods for identifying surgical NEC have been identified with varying overall performance and uncertainties about reproducibility and superiority of any method. External validation in large multicentre datasets should allow direct comparison of accuracy and prospective study should evaluate impact on clinical outcomes.
0031-3998
Bethell, George S.
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Jones, Ian H .
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Battersby, Cheryl
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Knight, Marian
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Hall, Nigel J.
6919e8af-3890-42c1-98a7-c110791957cf
Bethell, George S.
c7a62cc1-5573-41f6-ae00-3c11e8219dd4
Jones, Ian H .
f8e3a03c-d197-42ae-99e2-1f06f7f9bca5
Battersby, Cheryl
0813a186-cd73-45a6-b3e4-03022409e5cb
Knight, Marian
82cdb2d8-4ed6-445e-b749-e10c3f6dd146
Hall, Nigel J.
6919e8af-3890-42c1-98a7-c110791957cf

Bethell, George S., Jones, Ian H ., Battersby, Cheryl, Knight, Marian and Hall, Nigel J. (2024) Methods of identifying surgical necrotizing enterocolitis – a systematic review and meta-analysis. Pediatric Research. (In Press)

Record type: Article

Abstract

Background: current data suggests potential benefit of earlier surgery for necrotising enterocolitis (NEC) however this requires accurate prognostication early in the disease course. This study aims to identify and determine the effectiveness of previously reported methods or tests for the identification of surgical NEC.

Methods: systematic review and meta-analysis with registration on PROSPERO including articles describing a method of identifying surgical NEC. Outcomes of interest were effectiveness and repeatability of index test.

Results: of the 190 full-text articles screened, 90 studies were included which contained 114 methods of identifying surgical NEC in 9546 infants. Of these methods, 44 were a scoring system, 37 a single biomarker, 24 an imaging method and 9 an invasive method. Sensitivity and specificity ranged from 12.8-100% and 13-100%, respectively. Some methods (9.6%) provided insufficient methods for repeatability within clinical practice or research. Meta-analyses were possible for only 2 methods, the metabolic derangement 7 score and abdominal ultrasound.

Conclusions: a range of methods for identifying surgical NEC have been identified with varying overall performance and uncertainties about reproducibility and superiority of any method. External validation in large multicentre datasets should allow direct comparison of accuracy and prospective study should evaluate impact on clinical outcomes.

Text
Final accepted NEC SR - Accepted Manuscript
Restricted to Repository staff only until 16 November 2024.
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More information

Accepted/In Press date: 16 May 2024

Identifiers

Local EPrints ID: 490399
URI: http://eprints.soton.ac.uk/id/eprint/490399
ISSN: 0031-3998
PURE UUID: 42da751e-b3a6-4e24-a5e0-c04a7577f129
ORCID for George S. Bethell: ORCID iD orcid.org/0000-0002-1302-0735
ORCID for Nigel J. Hall: ORCID iD orcid.org/0000-0001-8570-9374

Catalogue record

Date deposited: 24 May 2024 16:43
Last modified: 14 Aug 2024 02:06

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Contributors

Author: George S. Bethell ORCID iD
Author: Ian H . Jones
Author: Cheryl Battersby
Author: Marian Knight
Author: Nigel J. Hall ORCID iD

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