University of Oulu

O’Brodovich, HM, Steinhorn, R, Ward, RM, et al. Development of a severity scale to assess chronic lung disease after extremely preterm birth. Pediatric Pulmonology. 2021; 56: 1583– 1592.

Development of a severity scale to assess chronic lung disease after extremely preterm birth

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Author: O'Brodovich, Hugh M.1; Steinhorn, Robin2; Ward, Robert M.3;
Organizations: 1Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
2Department of Pediatrics, University of California San Diego, San Diego, California, USA
3Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
4Oulu University Hospital, University of Oulu, Oulu, Finland
5Patient Centered Outcomes, ICON, Gaithersburg, Maryland, USA
6Patient Centered Outcomes, ICON, South San Francisco, California, USA
7Global Clinical Development, Rare Metabolic Diseases, Takeda, Zurich, Switzerland
8Global Clinical Development, Rare Metabolic Diseases, Takeda, Cambridge, Massachusetts, USA
9Global Evidence and Outcomes, Takeda, Lexington, Massachusetts, USA
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.8 MB)
Persistent link:
Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2021-06-29


Objective: Chronic lung disease of prematurity (CLDP) is a frequent complication of prematurity. We aimed to identify what clinicians believe are the most important factors determining the severity of CLDP in extremely preterm infants (<28 weeks gestational age) after discharge from the neonatal intensive care unit (NICU) through 12 months corrected age (CA), and to evaluate how these factors should be weighted for scoring, to develop a CLDP severity scale.

Study design: Clinicians completed a three-round online survey utilizing Delphi methodology. Clinicians rated the importance of various factors used to evaluate the severity of CLDP, from 0 (not at all important) to 10 (very important) for the period between discharge home from the NICU and 12 months CA. Fourteen factors were considered in Round 1; 13 in Rounds 2 and 3. The relative importance of factors was explored via a set of 16 single-profile tasks (i.e., hypothetical patient profiles with varying CLDP severity levels).

Results: Overall, 91 clinicians from 11 countries who were experienced in treating prematurity-related lung diseases completed Round 1; 88 completed Rounds 2 and 3. Based on Round 3, the most important factors in determining CLDP severity were mechanical ventilation (mean absolute importance rating, 8.89), supplemental oxygen ≥2 L/min (8.49), rehospitalizations (7.65), and supplemental oxygen <2 L/min (7.56). Single-profile tasks showed that supplemental oxygen had the greatest impact on profile classification.

Conclusion: The most important factors for clinicians assigning CLDP severity during infancy were mechanical ventilation, supplemental oxygen ≥2 L/min, and respiratory-related rehospitalizations.

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Series: Pediatric pulmonology
ISSN: 8755-6863
ISSN-E: 1099-0496
ISSN-L: 8755-6863
Volume: 56
Issue: 6
Pages: 1583 - 1592
DOI: 10.1002/ppul.25279
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: This study was funded by Takeda.
Copyright information: © 2021 The Authors. Pediatric Pulmonology Published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.