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Data Sources and Methods
The Committee on Understanding Premature Birth and Assuring Healthy Outcomes was asked to evaluate the state of the science on the causes and consequences of preterm birth. The committee assessed the various factors contributing to preterm birth; reviewed the economic, medical, social, psychological, and educational outcomes for children and families; addressed research gaps and needs; and explored changes in health policies.
To provide a comprehensive response to the study charge, the committee examined data from a variety of sources. These data sources included a review of recent scientific literature, public input through a series of workshops, and commissioned papers on selected topics. The study was conducted over a 21-month period.
DESCRIPTION OF THE STUDY COMMITTEE
A study committee composed of 17 members was assembled to assess the available data and make recommendations. The committee membership included individuals with expertise in obstetrics and gynecology, pediatrics, environmental health, epidemiology, psychology, economics, genetics, and public health. The committee convened for six 2-day meetings in March 2005, June 2005, August 2005, October 2005, December 2005, and January 2006.
LITERATURE REVIEW
Three strategies were combined to identify literature in support of the committee’s charge. First, a search on the EMBASE and Medline databases was conducted to obtain articles from peer-reviewed journals. The searches focused on preterm birth and low birth weight, including their genetic, behavioral, biological, and environmental causes, as well as their economic, educational, health, and family consequences. Second, the reports of federal agencies, such as the National Institutes of Health and the Centers for Disease Control and Prevention, relevant to preterm birth and low birth weight were also gathered. Finally, committee members and workshop participants submitted articles and reports on those topics. The resulting database included more than 800 articles and reports.
COMMISSIONED PAPERS
The study committee commissioned three papers intended to provide in-depth information on selected topics, beyond the independent analysis of the literature conducted by the committee. The topics of these papers included geographic variations in rates of preterm birth, prematurity-related ethical issues, and the economic costs associated with preterm birth. The members of the committee determined the topics and the authors of the papers. These papers were not intended to serve as substitutes for the committee’s own review and analysis of the literature. The committee independently deliberated on these topics before it received the drafts of the papers.
PUBLIC WORKSHOPS
The committee hosted three public workshops to gain additional information on specific aspects of the study charge. These workshops were held in conjunction with the March, June, and August meetings. The study committee determined the topics and the speakers.
The first workshop was intended to provide an overview of key issues in the area of preterm birth and to discuss the committee’s charge. Content focused on the biological pathways associated with preterm birth, as well as the educational, economic, and family consequences. Additionally, representatives from the study’s sponsors were invited to discuss the charge to the committee. The second workshop focused on the role of maternal conditions, such as infection, inflammation, and preeclampsia in preterm birth; the epidemiology of preterm birth; public policies that may address the problem of preterm birth; controversial issues in the care of preterm infants; and racial disparities in the rates of preterm birth. The third and final
workshop focused on barriers to clinical research. Specifically, presenters addressed issues related to the current state of the workforce, key issues in career development, ethics and liability issues in research, funding of research, drug development research, and the leadership required for the development of research capacity within departments of obstetrics and gynecology. Each workshop was open to the public; and individuals were invited to present information to the committee, discuss their presentations, and address inquiries from the committee. The agendas of these workshops, including the names of the workshop participants, are included in Boxes A-1 through A-3.
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BOX A-2 Institute of Medicine Committee on Understanding Premature Birth and Assuring Healthy Outcomes The National Academies Building 2100 C Street, NW Washington, D.C. Room 180 AGENDA Wednesday, June 22, 2005
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Thursday, June 23, 2005 Room 180
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BOX A-3 Institute of Medicine Committee on Understanding Premature Birth and Assuring Healthy Outcomes Keck Center of the National Academies 500 Fifth Street, NW Washington, D.C. Room 100 Public Workshop on Barriers to Clinical Research Related to Premature Birth Wednesday, August 10, 2005
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Thursday, August 11, 2005 Room 110
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