Evidence map›Paper›PMID 37169336›Full record

ArticleThe Journal of pediatrics2023

Generalizability of the Necrotizing Enterocolitis Surgery Trial to the Target Population of Eligible Infants.

Matthew A Rysavy, Barry Eggleston, Issa J Dahabreh, Jon E Tyson, Ravi M Patel, Kristi L Watterberg, Rachel G Greenberg, Claudia Pedroza, Marissa Trotta, David K Stevenson and 5 more

Registry-linked trialOpen access · greenAbstract read
In one paragraph

Article in The Journal of pediatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01029353 (A Multi-center Randomized Trial of Laparotomy vs. Drainage as the Initial Surgical Therapy for ELBW Infants With Necrotizing Enterocolitis), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01029353 nacompletednot on this map

A Multi-center Randomized Trial of Laparotomy vs. Drainage as the Initial Surgical Therapy for ELBW Infants With Necrotizing Enterocolitis (NEC) or Isolated Intestinal Perforation (IP): Outcomes at 18-22 Months Adjusted Age

TypeinterventionalSponsorNICHD Neonatal Research NetworkRan2010 to 2019Enrolled529ConditionsInfant, Newborn, Infant, Low Birth Weight, Infant, Small for Gestational Age, Infant, PrematureArmsLaparotomy, Drainage
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Surgical Interventions for NEC-An Overview.Children (Basel, Switzerland) · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 8 institutions in 1 country.

Matthew A RysavyMcGovern Medical School at McGovern Medical School at UTHealth Houston, Houston, TX; Children's Memorial Hermann Hospital, Houston, TX. Electronic address: matthew.a.rysavy@uth.tmc.edu.
Barry EgglestonRTI International, Research Triangle Park, NC.
Issa J DahabrehCAUSALab, Department of Epidemiology and Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA.
Jon E TysonMcGovern Medical School at McGovern Medical School at UTHealth Houston, Houston, TX.
Ravi M PatelEmory University School of Medicine, Atlanta, GA.
Kristi L WatterbergUniversity of New Mexico Health Sciences Center, Albuquerque, NM.
Rachel G GreenbergDuke University, Durham, NC.
Claudia PedrozaMcGovern Medical School at McGovern Medical School at UTHealth Houston, Houston, TX.
Marissa TrottaRTI International, Research Triangle Park, NC.
David K StevensonStanford University School of Medicine, Palo Alto, CA.
Barbara J StollMcGovern Medical School at McGovern Medical School at UTHealth Houston, Houston, TX; Emory University School of Medicine, Atlanta, GA.
Kevin P LallyMcGovern Medical School at McGovern Medical School at UTHealth Houston, Houston, TX; Children's Memorial Hermann Hospital, Houston, TX.
Abhik DasRTI International, Bethesda, MD.
Martin L BlakelyMcGovern Medical School at McGovern Medical School at UTHealth Houston, Houston, TX; Vanderbilt University Medical Center, Nashville, TN.
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
RTI International · USEmory University · USMemorial Hermann · USThe University of Texas Health Science Center at Houston · USDuke University · USPalo Alto University · USThe University of Texas Health Science Center · USUniversity of New Mexico · US

Funding

Neonatal Research Network Data Coordinating Center (DCC) 2023-2028U24HD095254 · NICHD · RESEARCH TRIANGLE INSTITUTE · PI Abhik Das · 2018 to 2026
$70.2M
NICHD Cooperative Multicenter Neonatal Research NetworkU10HD040492 · NICHD · DUKE UNIVERSITY · PI COTTEN, CHARLES MICHAEL · 2001 to 2015
$5.4M
NICHD Neonatal Research Network -- Cincinnati Clinical CenterUG1HD027853 · NICHD · CINCINNATI CHILDRENS HOSP MED CTR · PI STEPHANIE L MERHAR · 2016 to 2026
$3.7M
North Carolina Clinical CenterUG1HD040492 · NICHD · DUKE UNIVERSITY · PI CHARLES Michael COTTEN, Matthew Laughon · 2016 to 2026
$3.4M
NICHD Cooperative Multicenter Neonatal Research Network - Utah CenterUG1HD087226 · NICHD · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI ROBIN K OHLS · 2016 to 2026
$3.3M
NICHD Neonatal Research Network - Stanford UniversityUG1HD027880 · NICHD · STANFORD UNIVERSITY · PI Valerie Chock · 2016 to 2026
$3.3M
Eunice Kennedy Shriver NICHD Cooperative Multicenter Neonatal ResearchNetworkUG1HD053089 · NICHD · UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR · PI Janell Fuller, Jessie R. Maxwell · 2016 to 2026
$3.2M
NICHD Cooperative Multicenter Neonatal Research NetworkU10HD053089 · NICHD · UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR · PI WATTERBERG, KRISTI L. · 2006 to 2015
$3.2M
NICHD Cooperative Multicenter Neonatal Research NetworkU10HD053109 · NICHD · UNIVERSITY OF IOWA · PI BELL, EDWARD F · 2006 to 2015
$3.1M
NICHD Neonatal Research NetworkUG1HD027851 · NICHD · EMORY UNIVERSITY · PI Ravi Mangal Patel · 2016 to 2026
$3.0M
Multicenter Network of Neonatal Intensive Care Units-University of Texas at Houston (UT Houston) Clinical CenterUG1HD087229 · NICHD · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI TYSON, JON E. · 2016 to 2022
$2.0M
NICHD Neonatal Research Network (NRN): Clinical Centers (UG1 Clinical Trial OptionalUG1HD112093 · NICHD · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI Matthew Albert Rysavy · 2023 to 2026
$1.4M
NICHD NIH HHS F32 HD098782NICHD NIH HHS U10 HD040492NICHD NIH HHS U10 HD053089NICHD NIH HHS U10 HD053109NICHD NIH HHS U24 HD095254NICHD NIH HHS UG1 HD027851NICHD NIH HHS UG1 HD027853NICHD NIH HHS UG1 HD027880NICHD NIH HHS UG1 HD040492NICHD NIH HHS UG1 HD053089NICHD NIH HHS UG1 HD087226NICHD NIH HHS UG1 HD087229
6 · The paper itself

Abstract

objectiveThe objective of this study was to evaluate whether infants randomized in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Necrotizing Enterocolitis Surgery Trial differed from eligible infants and whether differences affected the generalizability of trial results. STUDY

designSecondary analysis of infants enrolled in Necrotizing Enterocolitis Surgery Trial (born 2010-2017, with follow-up through 2019) at 20 US academic medical centers and an observational data set of eligible infants through 2013. Infants born ≤1000 g and diagnosed with necrotizing enterocolitis or spontaneous intestinal perforation requiring surgical intervention at ≤8 weeks were eligible. The target population included trial-eligible infants (randomized and nonrandomized) born during the first half of the study with available detailed preoperative data. Using model-based weighting methods, we estimated the effect of initial laparotomy vs peritoneal drain had the target population been randomized.

resultsThe trial included 308 randomized infants. The target population included 382 (156 randomized and 226 eligible, non-randomized) infants. Compared with the target population, fewer randomized infants had necrotizing enterocolitis (31% vs 47%) or died before discharge (27% vs 41%). However, incidence of the primary composite outcome, death or neurodevelopmental impairment, was similar (69% vs 72%). Effect estimates for initial laparotomy vs drain weighted to the target population were largely unchanged from the original trial after accounting for preoperative diagnosis of necrotizing enterocolitis (adjusted relative risk [95% CI]: 0.85 [0.71-1.03] in target population vs 0.81 [0.64-1.04] in trial) or spontaneous intestinal perforation (1.02 [0.79-1.30] vs 1.11 [0.95-1.31]).

conclusionDespite differences between randomized and eligible infants, estimated treatment effects in the trial and target population were similar, supporting the generalizability of trial results.

trial registrationClinicalTrials.gov ID: NCT01029353.

Indexed as

Enterocolitis, NecrotizingInfant, Newborn, DiseasesInfant, Premature, DiseasesIntestinal PerforationChildHumansInfantInfant, NewbornLaparotomygeneralizabilitynecrotizing enterocolitisrandomized clinical trialsspontaneous intestinal perforation

Identifiers

PMID37169336
PMCPMC10632546
OpenAlexW4375945374

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.