Optimising neurodevelopmental and psychosocial outcomes for survivors with CHD: a research agenda for the next decade
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Published on: May 26, 2023
Erica Sood1,2, Jeffrey P Jacobs3,4, Bradley S Marino5
1Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, DE, USA.
Insights
Survivors of congenital heart disease (CHD) face neurodevelopmental challenges impacting quality of life. This study outlines a research agenda to improve neuroprotection and interventions for better long-term outcomes.
Area of Science:
- Pediatric Cardiology
- Neurodevelopmental Disorders
- Psychosocial Health
Background:
- Congenital heart disease (CHD) survivors experience neurodevelopmental and psychosocial impairments affecting quality of life and independence.
- Risk factors are multifactorial, including genetic, fetal, surgical, and social elements, necessitating comprehensive neuroprotection strategies.
Purpose of the Study:
- To establish a 10-year research agenda for cardiac neurodevelopmental and psychosocial outcomes.
- To identify critical knowledge gaps and guide future scientific investigation in the field.
Main Methods:
- Convened international experts in cardiac neurodevelopment, psychosocial research, clinical care, and health disparities.
- Formed seven multidisciplinary working groups focusing on key research domains.
- Included patient and family stakeholders in agenda development.
Main Results:
- Identified significant gaps in knowledge across all seven working group domains.
- Defined critical research questions essential for advancing cardiac neurodevelopmental and psychosocial outcomes.
- Highlighted the need for a structured research agenda to inform funding and collaborative efforts.
Conclusions:
- A prioritized research agenda is crucial for advancing cardiac neurodevelopmental and psychosocial outcomes.
- Addressing knowledge gaps will improve care, policy, and long-term outcomes for CHD survivors.
- Collaborative research initiatives are vital to reduce the burden of CHD on individuals and society.
Abstract:
Neurodevelopmental and psychosocial impairments negatively impact health-related quality of life for survivors with CHD and complicate the transition to independent adulthood. Risk for neurodevelopmental and psychosocial impairments is influenced by a complex interplay among genetic, foetal, surgical, perioperative, family, and social factors, requiring a multi-pronged approach to neuroprotection and intervention. To ensure future research can ultimately reduce the burden of CHD for individuals, families, and society, the most pressing issues in cardiac neurodevelopment requiring scientific investigation must be identified.Through funding from an R13 Grant from the National Heart, Lung, and Blood Institute of the National Institutes of Health of the United States of America, the Cardiac Neurodevelopmental Outcome Collaborative convened a two-day meeting of international experts in cardiac neurodevelopmental and psychosocial research, clinical care, and health disparities, including patient and family stakeholders, to define the cardiac neurodevelopmental and psychosocial outcomes research agenda for the next decade. Seven multidisciplinary working groups were formed to address key domains crucial to the advancement of cardiac neurodevelopmental and psychosocial outcomes research: 1) Foetal Brain Development and Neuroprotection, 2) Surgical/Perioperative Neuroprotection and Neurodevelopment, 3) Characterization of Neurodevelopmental and Psychological Outcomes, 4) Neurodevelopmental and Psychosocial Intervention, 5) Parent Mental Health and Family Functioning, 6) Neurodevelopmental Education, Outreach and Advocacy, and 7) Health Disparities and Neurodevelopmental Outcomes. Working groups identified significant gaps in knowledge and critical questions that must be answered to further knowledge, policy, care, and outcomes. The development of a research agenda in cardiac neurodevelopmental and psychosocial outcomes is critical for informing collaborative initiatives and allocation of funding for research to scientific inquiries of highest value to key stakeholders.
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