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Is noxious stimulus-evoked electroencephalography response a reliable, valid, and interpretable outcome measure to assess analgesic efficacy in neonates? A systematic review and individual participant data (IPD) meta-analysis protocol

Title: Is noxious stimulus-evoked electroencephalography response a reliable, valid, and interpretable outcome measure to assess analgesic efficacy in neonates? A systematic review and individual participant data (IPD) meta-analysis protocol
Authors: Baxter, L; van der Vaart, M; Cobo, MM; Gunawan, PY; Allegaert, K; Davis, JM; Turner, M; Ward, RM; Darsey, E; Sheppard, JP; Bhatt, A; van den Anker, J; Massaro, AN; Walls, RL; Song, LS; Singh, K; Vivas, N; Reginato Cascamo, K; Mehta, V; Matthews, D; Jackson, Y; Hovinga, C; Giola, O; Discenza, D; Barry, C; Arimistu, T; Apele-Freimane, D; Slater, R
Publisher Information: Springer Science and Business Media LLC
Publication Year: 2025
Collection: The University of Liverpool Repository
Description: Background: There are several major challenges limiting our ability to test analgesic efficacy for treatment of neonatal pain, and progress in analgesic drug studies in neonates has stalled. One significant issue is the reliance of clinical pain assessments on traditional behavioural and vital signs-based measures and the exclusion of novel brain-based biomarkers. In this review protocol, we outline our strategy to assess the reliability, validity, and interpretability of an electroencephalography (EEG)-based response biomarker for assessment of acute somatic nociceptive pain in neonates. Methods: To standardise EEG analysis and generate the outcome of interest, we will perform an individual participant data (IPD) meta-analysis using data from neonates aged 34–44-week postmenstrual age that have had EEG recorded during acute somatic nociceptive skin-breaking procedures. Relevant data from both published and grey literature will be identified by searching six databases (MEDLINE, Embase, CINAHL, Web of Science, Scopus, Google Scholar), two clinical trial registry platforms (ClinicalTrials.gov, WHO ICTRP), and by consulting expert opinion. We will assess availability bias, data accuracy, and data quality by cross-referencing provided data with data descriptions in the literature, identifying duplicates and nonsensical values, and extracting quality control metrics. Data will be synthesised via a two-stage IPD meta-analysis using a random effects modelling approach grouped by site. Reliability (inter- and intra-rater) outcomes will be measured as Gwet’s AC1 coefficient. Validity (known-groups and known-stimuli) outcomes will be measured as EEG response magnitude differences between clinically meaningfully different stimuli. Interpretability will be addressed by providing normative values, in both original and standardised units. Discussion: The purpose of this study is to establish the reliability, validity, and interpretability of a specific EEG-based response biomarker for assessing acute somatic nociceptive pain ...
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 2046-4053
Relation: https://livrepository.liverpool.ac.uk/3193899/1/Is%20noxious%20stimulus-evoked%20electroencephalography%20response%20a%20reliable,%20valid,%20and%20interpretable%20outcome%20measure%20to%20assess%20an.pdf; Collapse authors list. Baxter, L orcid:0000-0001-9548-7162 , van der Vaart, M, Cobo, MM, Gunawan, PY, Allegaert, K, Davis, JM, Turner, M orcid:0000-0002-5299-8656 , Ward, RM, Darsey, E, Sheppard, JP et al (show 18 more authors) , Bhatt, A, van den Anker, J, Massaro, AN, Walls, RL, Song, LS, Singh, K, Vivas, N, Reginato Cascamo, K, Mehta, V, Matthews, D, Jackson, Y, Hovinga, C, Giola, O, Discenza, D, Barry, C, Arimistu, T, Apele-Freimane, D and Slater, R (2025) Is noxious stimulus-evoked electroencephalography response a reliable, valid, and interpretable outcome measure to assess analgesic efficacy in neonates? A systematic review and individual participant data (IPD) meta-analysis protocol Systematic Reviews, 14 (1). 152-. ISSN 2046-4053, 2046-4053
DOI: 10.1186/s13643-025-02890-4
Availability: https://livrepository.liverpool.ac.uk/3193899/; https://doi.org/10.1186/s13643-025-02890-4
Rights: cc_by_4
Accession Number: edsbas.2F4CFC14
Database: BASE