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Update neonatal decision tree table with RDS data inputs #1584

Merged
merged 9 commits into from
Jan 28, 2025
Original file line number Diff line number Diff line change
Expand Up @@ -380,15 +380,28 @@ V&V Checks:
- XX relative risk on incidence of encephalopathy if birthing parent experiences obstructed labor
- Need to determine how neonatal mortality in general will be modeled and how we will handle overlaps with preterm and LBWSG RR's on all cause mortality
* - 7
- XX% of each type of facility have CPAP or NICU capabilities
-
- Percentage of each facility type that have CPAP capabilities: CMONC - 39.3% and BMONC - 7.5%
- These values are from the 2016 EmONC Final Report and are therefore only reflective of Ethiopian health system a decade ago. Please use these as a placeholder for now while we
try to find reliable values for Nigeria and Pakistan.
* - 8
- XX relative risk on RDS mortality of facility having CPAP or NICU capabilities vs. not
- Need to confirm this will impact mortality not incidence. Also need to determine how neonatal mortality in general will be modeled and how we will handle overlaps with preterm and LBWSG RR's on all cause mortality
- 0.53 (95% CI 0.34-0.83) relative risk on RDS mortality of neonate receiving CPAP
- Note that we might want RR for NICU, but this value is for CPAP. The population that this effect size applies to is
preterm infants with "respiratory failure becoming evident soon after birth".
Source: `2020 Cochrane review <https://pmc.ncbi.nlm.nih.gov/articles/PMC8094155/>`_
* - 9
- XX relative risk for RDS incidence based on birthing parent receiving antenatal corticosteroids
- Need to confirm this will impact incidence not mortality. Also need to determine how neonatal mortality in general will be modeled and how we will handle overlaps with preterm and LBWSG RR's on all cause mortality

- 0.69 (95% CI 0.59-0.81) relative risk for RDS mortality based on birthing parent receiving antenatal corticosteroids
- This value is for RDS mortality, however there is also an RR on RDS incidence (0.66, 95% CI 0.56-0.77). Study recipients
of RDS intervention included "women, with a singleton or multiple pregnancy, expected to deliver preterm as a result of either
spontaneous preterm labour, preterm prelabour rupture of the membranes or planned preterm delivery."
Source: `2017 Cochrane review <https://pubmed.ncbi.nlm.nih.gov/28321847/>`_
* - 10
- Percentage of preterm deaths caused by RDS: Ethiopia - 87.1%; Nigeria - 98.1%; Pakistan - 89.7%
- Ethiopia source: `Major causes of death in preterm infants in selected hospitals in Ethiopia <https://www.sciencedirect.com/science/article/pii/S2214109X19302207>`_
Nigeria source: `Current Trends in Neonatal Morbidity and Mortality - Experiences from a Tertiary Center in Lagos, Nigeria <https://pmc.ncbi.nlm.nih.gov/articles/PMC9490664/>`_
Pakistan source: `Birth asphyxia is under-rated as a cause of preterm neonatal mortality in low- and middle-income countries <https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.17220>`_
Note about the Pakistan paper: the study provides two estimates of preterm deaths caused by RDS, and the value above is based on physician diagnoses, but the authors also
had a panel of experts review the diagnoses independently, and the panel found RDS to be far less common than the physicians, with 35.6% of preterm deaths attributed to RDS.

.. _inputs_to_neonatal_decision_tree_table:

.. list-table:: Inputs to Neonatal Decision Tree
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