Outcomes in pediatric studies of medium-chain acyl-coA dehydrogenase (MCAD) deficiency and phenylketonuria (PKU): a review

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dc.contributor.authorPugliese, Michael
dc.contributor.authorTingley, Kylie
dc.contributor.authorChow, Andrea
dc.contributor.authorPallone, Nicole
dc.contributor.authorSmith, Maureen
dc.contributor.authorRahman, Alvi
dc.contributor.authorChakraborty, Pranesh
dc.contributor.authorGeraghty, Michael T
dc.contributor.authorIrwin, Julie
dc.contributor.authorTessier, Laure
dc.contributor.authorNicholls, Stuart G
dc.contributor.authorOffringa, Martin
dc.contributor.authorButcher, Nancy J
dc.contributor.authorIverson, Ryan
dc.contributor.authorClifford, Tammy J
dc.contributor.authorStockler, Sylvia
dc.contributor.authorHutton, Brian
dc.contributor.authorPaik, Karen
dc.contributor.authorTao, Jessica
dc.contributor.authorSkidmore, Becky
dc.contributor.authorCoyle, Doug
dc.contributor.authorDuddy, Kathleen
dc.contributor.authorDyack, Sarah
dc.contributor.authorGreenberg, Cheryl R
dc.contributor.authorGhai, Shailly J
dc.contributor.authorKarp, Natalya
dc.contributor.authorKorngut, Lawrence
dc.contributor.authorKronick, Jonathan
dc.contributor.authorMacKenzie, Alex
dc.contributor.authorMacKenzie, Jennifer
dc.contributor.authorMaranda, Bruno
dc.contributor.authorMitchell, John J
dc.contributor.authorPotter, Murray
dc.contributor.authorPrasad, Chitra
dc.contributor.authorSchulze, Andreas
dc.contributor.authorSparkes, Rebecca
dc.contributor.authorTaljaard, Monica
dc.contributor.authorTrakadis, Yannis
dc.contributor.authorWalia, Jagdeep
dc.contributor.authorPotter, Beth K
dc.date.accessioned2020-01-19T01:02:30Z
dc.date.available2020-01-19T01:02:30Z
dc.date.issued2020-01-14
dc.date.updated2020-01-19T01:02:29Z
dc.description.abstractAbstract Background Inherited metabolic diseases (IMDs) are a group of individually rare single-gene diseases. For many IMDs, there is a paucity of high-quality evidence that evaluates the effectiveness of clinical interventions. Clinical effectiveness trials of IMD interventions could be supported through the development of core outcome sets (COSs), a recommended minimum set of standardized, high-quality outcomes and associated outcome measurement instruments to be incorporated by all trials in an area of study. We began the process of establishing pediatric COSs for two IMDs, medium-chain acyl-CoA dehydrogenase (MCAD) deficiency and phenylketonuria (PKU), by reviewing published literature to describe outcomes reported by authors, identify heterogeneity in outcomes across studies, and assemble a candidate list of outcomes. Methods We used a comprehensive search strategy to identify primary studies and guidelines relevant to children with MCAD deficiency and PKU, extracting study characteristics and outcome information from eligible studies including outcome measurement instruments for select outcomes. Informed by an established framework and a previously published pediatric COS, outcomes were grouped into five, mutually-exclusive, a priori core areas: growth and development, life impact, pathophysiological manifestations, resource use, and death. Results For MCAD deficiency, we identified 83 outcomes from 52 articles. The most frequently represented core area was pathophysiological manifestations, with 33 outcomes reported in 29/52 articles (56%). Death was the most frequently reported outcome. One-third of outcomes were reported by a single study. The most diversely measured outcome was cognition and intelligence/IQ for which eight unique measurement instruments were reported among 14 articles. For PKU, we identified 97 outcomes from 343 articles. The most frequently represented core area was pathophysiological manifestations with 31 outcomes reported in 281/343 articles (82%). Phenylalanine concentration was the most frequently reported outcome. Sixteen percent of outcomes were reported by a single study. Similar to MCAD deficiency, the most diversely measured PKU outcome was cognition and intelligence/IQ with 39 different instruments reported among 82 articles. Conclusions Heterogeneity of reported outcomes and outcome measurement instruments across published studies for both MCAD deficiency and PKU highlights the need for COSs for these diseases, to promote the use of meaningful outcomes and facilitate comparisons across studies.
dc.identifier.citationOrphanet Journal of Rare Diseases. 2020 Jan 14;15(1):12
dc.identifier.doihttps://doi.org/10.1186/s13023-019-1276-1
dc.identifier.urihttp://hdl.handle.net/1880/111515
dc.identifier.urihttps://doi.org/10.11575/PRISM/44252
dc.language.rfc3066en
dc.rights.holderThe Author(s).
dc.titleOutcomes in pediatric studies of medium-chain acyl-coA dehydrogenase (MCAD) deficiency and phenylketonuria (PKU): a review
dc.typeJournal Article
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