Studies identified in our initial database search Study Reason for exclusion Adams 1998 [1] This paper described the rationale behind the design of a clinical trial investigating stroke prevention in children with sickle cell anaemia. The paper did not, however, develop or use methodology for selecting the outcomes used in the trials. Allen 1985[2] This review article discussing design issues in clinical trials of children with brain tumours is based on the author’s personal opinion. Although features of some outcomes are discussed, this does not qualify as methodology of selecting outcomes. Andrasik 2005[3] This review article discussing design issues in clinical trials of children with headache is based on the author’s personal opinion. Although features of some outcomes are discussed, methodology of selecting outcomes is not used or developed. Arnold 2003[4] This study validated the use of parent-reported outcomes in clinical trials of children with autism. The study was excluded, however, because it did not relate to the actual methodology of selecting an outcome, but the validation of an outcome which was already selected. Ball 2003[5] This study aimed to develop a definition of what constitutes a ‘responder’ in clinical trials of children with abdominal pain. Therefore the authors used methodology to refine an existing outcome, rather than using methodology for selecting outcomes for use in clinical trials of children with abdominal pain. Beghi 1993[6] This paper describes the rationale behind the design of a clinical trial, including the outcomes which were selected. The paper did not, however, describe methodology for selecting outcomes for use in clinical trials. Bower 1994[7] The review article discussed in detail the potential ways of measuring outcomes, but did not describe the selection of outcomes for use in clinical trials of children with cerebral palsy. Children’s This paper described the rationale behind various aspects of a clinical trial Amalgam Trial in children requiring dental restoration. The authors do not describe the Study Group [8] methodology behind selecting the outcome. Curley 2005[9] This review article aims to review the performance characteristics of outcomes used in clinical trials in children with sepsis. The study does not, however, use methodology for selecting outcomes for use in these trials. Curley 2006[10] This paper describes the rationale behind the design of a clinical trial, including the outcomes which were selected. The paper did not, however, describe methodology for selecting outcomes for use in clinical trials. Furst 2005[11] The review article does discuss scleroderma in paediatric trials, but discusses how to measure an outcome, rather than select one. Guilbert 2004[12] This paper described the rationale behind the design of a clinical trial, but did not explain the methodology behind selecting the outcomes measured in the study. Hargrave 2006[13] In this review article the authors appraised the consistency between different studies of children with brainstem glioma. The authors do not use methodology for selecting outcome measures for use in clinical trials, nor do they review the methodology that other authors use for this purpose. Hollander 2004[14] This review article related to study design in clinical trials of children with autism. Because it was a commentary based on the personal opinion of the author it was excluded, as it did not describe methodology for selecting outcomes for use in clinical trials. Juniper 2001[15] The study did not use methodology for selecting outcomes, and was not relevant specifically to children King 2004[16] This systematic review did not use methodology for selecting outcomes in clinical trials, but did suggest outcomes for use in future bronchiolitis clinical trials. Kirkham 2004[17] This article reviews clinical trial design issues in children with arterial stroke, and suggests strategies for future studies, but does not discuss selection of outcomes or use methodology for selecting outcomes. Law 1989[18] This review article relates to several aspects of clinical trial design in the field of occupational therapy. Although characteristics of instruments for measuring outcomes are reviewed, the selection of outcomes or outcome domains is not. Mahoney 2006[19] This article described the work of a research network for paediatric cardiology clinical trials, including work on validating outcomes for use in clinical trials. The article did not, however, describe studies which use methodology for selecting which outcomes should be measured in clinical trials of children with cardiology problems. Marshall 2005[20] Although the article does quote some paediatric trials, it does not specifically state that the outcomes can be used in paediatric research. Martin 2006[21] This consensus statement relates to clinical trial design in adults with graftversus-host disease (GVHD), but the authors do not specifically state that the outcomes suggested are for use in paediatric trials. McBride 1990 [22] This review article is about outcomes in clinical trials of infants with bronchiolitis. The article does not describe or develop a methodology for selecting outcomes though. McDaid 2005[23] At the end of this systematic review of treatments for retinoblastoma, the authors suggest outcomes for use in future clinical trials. These suggestions are a result of the methodological assessment of previously published studies, but not a result of methodology which the authors used to determine the most appropriate outcomes to use. Mehta 2003 [24] This study reviews outcomes in trials of adults with renal failure, but not children. Meltzer 2006[25] Paper mentioned several outcome measures as part of guidelines for clinical trials in rhinosinusitis, but did not discuss the process or methodology of selecting them. Mohanraj 2003 [26] In this review article authors compare outcomes used to measure various outcome domains in clinical trials of children with epilepsy. The article does not, however, use methodology to select outcomes or outcome domains. Ozolins 2005 [27] In the discussion section of this clinical trial of children with acne, the author assesses the performance characteristics of some of the outcomes which were used during the study, but he does not discuss outcome domains which should be selected in future trials, or use methodology to select outcomes. Pauwels 2001 [28] This paper discusses aspects of the design of a clinical trial in children with asthma. The author does not describe the methodology used to select the outcome domains or outcomes. Ravelli 1997 [29] This study assessed the collinearity between outcomes used in clinical trials of children with rheumatoid arthritis. Although the authors, therefore, assess performance characteristics of some outcomes, they do not use methodology for selecting outcomes for use in clinical trials. Romagnoli 2001 This clinical trial assessed the long-term effects of steroids on newborn [30] infants. The authors, when discussing design issues relevant to possible future clinical trials, suggest outcomes for use in these trials. However, the authors do not use methodology to select these outcomes. Rosenfeld 2001 This study aimed to define ‘exacerbations’ as an outcome for use in clinical [31] trials in children with cystic fibrosis. The study did not, however, aim to select outcomes for use in these clinical trials. Rudorfer 1993 [32] In this review article, the author reviews tools and instruments for measuring outcomes in clinical trials of children with psychiatric illness, but does not use methodology to select outcomes or outcomes that should be used in these studies. Ruperto 1996 [33] This study assessed the redundancy of outcomes used in clinical trials of children with rheumatoid arthritis. Although the authors, therefore, assess performance characteristics of some outcomes, they do not use methodology for selecting outcomes for use in clinical trials. Schoenfeld 2002 The article discusses a study in which the participants were all adults. [34] Schonbeck 2005 This paper describes the rationale behind several aspects of a clinical trial [35] of influenza and pneumococcal vaccination, but the authors do not describe methodology used to select the outcomes measured in the trial. Shapiro 1999 [36] The article describes several aspects of trial design in a clinical trial of children with asthma, but the authors do not describe the methodology used to select the outcomes. Sharek 2002 [37] This study assesses the collinearity between five different measures of asthma status, but does not use methodology to actually select outcomes for clinical trials. Spahn 2003 [38] This literature review assesses some of the performance characteristics of outcomes used in clinical research in asthma, but the author does not use methodology to identify which outcomes should be used in future clinical trials. Spencer 1997 [39] The article does not use methodology for selecting outcome measures for use in trials. It relates to the change in distribution of the DMF index, an outcome used in clinical trials in dentistry. The author suggests outcomes for use in future clinical trials, but does not use methodology for selecting these outcomes. Thase 1999 [40] This is a review article which does not use methodology for selecting outcomes for use in clinical trials. The article does not relate to clinical trials in children. Theander 2005 [41] The study does not relate to clinical trials in children. Van Zanten 2006 [42] The article discusses validation of an instrument to measure an outcome (dyspepsia), rather than using methodology to select one. It is a study in adults. Walsh 2003 [43] In this study, the authors attempt to develop a physiological definition for bronchopulmonary dysplasia, a widely used outcome in neonatal trials. In other words, the authors are not using methodology for selecting outcomes, but improving the performance characteristics of an existing outcome. Walsh 2004[44] In this study, the authors assess the effect of a physiological definition on the incidence of bronchopulmonary dysplasia. The study does not select outcomes for use in future clinical trials. Zhang 2000 [45] This study assesses the performance characteristics of outcomes used in neonatal clinical trials, but is not about selection of outcome domains or outcomes. Studies suggested by MCRN CSG members Study Reason for exclusion Aurora 2005[46] In this study the correlation of various tests of lung function in children with CF was assessed. The study did not relate to the selection of which outcomes should be measured in clinical trials. Brody 2004[47] In this study the authors assessed the correlation between high resolution CT scanning and pulmonary function tests in children with CF. The authors do not use methodology to determine which outcomes should actually be measured in clinical trials of children with CF however. Clayton 2002[48] Consensus about management of children with 21-hyroxylase deficiency, not relating to clinical trial design Clayton 2005[49] Consensus about management of children treated with Growth Hormone, not relating to clinical trial design. Dunger 2004[50] Consensus statement about management of children with Diabetic Ketoacidosis, not relating to clinical trial design Hughes 2006[51] Consensus statement about children suffering from intersex disorders, not relating to clinical trial design. Lum 2007[52] In this study the authors assessed the extent at which multiple breath washout parameters are able to detect airway dysfunction in children with CF. The study did not relate to the selection of outcomes for use in clinical trials. Ordonez 2003[53] This study assesses the performance characteristics of inflammatory and microbiological markers in clinical trials of children with cystic fibrosis. The authors do not use methodology to determine which outcomes should actually be measured in these clinical trials however. Ordonez 2004[54] In this study the authors assess the reproducibility of inflammatory markers as an outcome measure in children with CF. The authors do not use methodology to determine which outcomes should actually be measured in clinical trials of children with CF however. Ratjen 2006[55] In this review article the authors discuss some ways of measuring airway inflammation in children with CF. They do not use methodology however to determine which outcomes should be measured in clinical trials if children with this condition. Suri 2003[56] In this study the authors assess the safety and usefulness of inducing sputum from children with CF in order to measure various inflammatory and microbiological markers that could be used as outcomes in clinical trials. The study does not use methodology to determine which outcomes should actually be measured in clinical trials of children with CF. Whitehouse 2007[57] In this study consumers were involved in the design of a clinical trial of children with migraine. The consumers were not involved in the selection of which outcomes should be measured in the trial (personal communication from Dr Whitehouse) References 1. Adams RJ, McKie VC, Brambilla D, Carl E, Gallagher D et al(1998) Stroke Prevention Trial in Sickle Cell Anemia. Controlled Clinical Trials 19: 110-129. 2. Allen JC (1985) The design and conduct of clinical trials in childhood brain tumors. Cancer 56(7 Suppl):1827-31, 3. Andrasik F, Powers SW, McGrath PJ (2005) Methodological considerations in research with special populations: children and adolescents. Headache 45(5):520-5, 4. Arnold LE, Vitiello B, McDougle C, Scahill L, Shah B et al(2003) Parentdefined target symptoms respond to risperidone in RUPP autism study: customer approach to clinical trials. Journal of the American Academy of Child & Adolescent Psychiatry 42(12):1443-50, 5. Ball TM, Weydert JA (2003) Methodological challenges to treatment trials for recurrent abdominal pain in children. Archives of Pediatrics & Adolescent Medicine 157: 1121-1127. 6. Beghi E, Musicco M, Viani F, Bordo B, Hauser WA, Nicolosi A (1993) A randomized trial on the treatment of the first epileptic seizure. Scientific background, rationale, study design and protocol. First Seizure Trial Group (FIR.S.T. Group). Italian journal of neurological sciences 14: 295-301. 7. Bower E, McLellan DL (1994) Evaluating therapy in cerebral palsy. Child: Care, Health and Development 20: 409-419. 8. Children's Amalgam Trial Study Group (2003) The Children's Amalgam Trial: design and methods. Controlled Clinical Trials 24(6):795-814, 9. Curley MA, Zimmerman JJ (2005) Alternative outcome measures for pediatric clinical sepsis trials. [Review] [77 refs]. Pediatric Critical Care Medicine 6(3 Suppl):S150-6, 10. Curley MAQ, Arnold JH, Thompson JE, Fackler JC, Grant MJ et al (2006) Clinical trial design-effect of prone positioning on clinical outcomes in infants and children with acute respiratory distress syndrome. Journal of Critical Care 21: 23-32. 11. Furst DE, Khanna D, Mattucci-Cerinic M, Silman AJ, Merkel PA, Foeldvari I, Special Interest Group (2005) Scleroderma--developing measures of response. Journal of Rheumatology 32(12):2477-80, 12. Guilbert TW, Morgan WJ, Krawiec M, Lemanske RF, Sorkness C et al (2004) The Prevention of Early Asthma in Kids study: design, rationale and methods for the Childhood Asthma Research and Education network. Controlled clinical trials 25: 286-310. 13. Hargrave D, Bartels U, Bouffet E (2006) Diffuse brainstem glioma in children: critical review of clinical trials. [Review] [46 refs]. Lancet Oncology 7(3):241-8, 14. Hollander E, Phillips A, King BH, Guthrie D, Aman MG, Law P, Owley T, Robinson R (2004) Impact of Recent Findings on Study Design of Future Autism Clinical Trials. CNS Spectrums 9: 49-56. 15. Juniper EF, Norman GR, Cox FM, Roberts JN (2001) Comparison of the standard gamble, rating scale, AQLQ and SF-36 for measuring quality of life in asthma. Eur Respir J 18: 38-44. 16. King VJ, Viswanathan M, Bordley WC, Jackman AM, Sutton SF et al [70 refs]. Archives of Pediatrics & Adolescent Medicine 158(2):127-37, 17. Kirkham F, Bire G, Steinlin M, ter R (2004) Arterial ischaemic stroke in children. Review of the literature and strategies for future stroke studies. Thrombosis and Haemostasis 92: 697-706. 18. Law M, Cadman D, Rosenbaum P, Russell D, DeMatteo C et al (1989) Evaluation of treatment in occupational therapy: methodology issues in conducting clinical trials... part 1. Canadian Journal of Occupational Therapy 56: 236-242. 19. Mahony L, Sleeper LA, Anderson PA, Gersony WM, McCrindle BW et al(2006) The Pediatric Heart Network: a primer for the conduct of multicenter studies in children with congenital and acquired heart disease. Pediatric Cardiology 27(2):191-8, -Apr. 20. Marshall J, Vincent J-L, Guyatt G, Angus D, Abraham E (2005) Outcome measures for clinical research in sepsis: A report of the 2nd Cambridge Colloquium of the International Sepsis Forum. Critical Care Medicine 33: 1708-1716. 21. Martin PJ, Weisdorf D, Przepiorka D, Hirschfeld S, Farrell A et al(2006) National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: VI. Design of Clinical Trials Working Group report. [18 refs]. Biology of Blood & Marrow Transplantation 12(5):491-505, 22. McBride JT (1990) Study design considerations for ribavirin: Efficacy studies. Pediatric Infectious Disease Journal 9: 23. McDaid C, Hartley S, Bagnall AM, Ritchie G, Light K, Riemsma R (2005) Systematic review of effectiveness of different treatments for childhood retinoblastoma. Health technology assessment (Winchester, England) 9: 24. Mehta RL (2003) Outcomes research in acute renal failure. Seminars in Nephrology 23: 283-294. 25. Meltzer EO, Hamilos DL, Hadley JA, Lanza DC, Marple BF et al (2006) Rhinosinusitis: Developing guidance for clinical trials. Journal of Allergy and Clinical Immunology 118: 26. Mohanraj R, Brodie MJ (2003) Measuring the efficacy of antiepileptic drugs. Seizure 12: 413-443. 27. Ozolins M, Eady EA, Avery A, Cunliffe WJ, O'Neill C et al (2005) Randomised controlled multiple treatment comparison to provide a cost-effectiveness rationale for the selection of antimicrobial therapy in acne. Health Technology Assessment 9: iii-iiv. 28. Pauwels RA, Busse WW, O'Byrne PM, Pedersen S, Tan WC et al (2001) The inhaled Steroid Treatment as Regular Therapy in early asthma (START) study: rationale and design. Controlled clinical trials 22: 405-419. 29. Ravelli A, Viola S, Ruperto N, Corsi B, Ballardini G, Martini A (1997) Correlation between conventional disease activity measures in juvenile chronic arthritis. Ann Rheum Dis 56: 197-200. 30. Romagnoli C, Zecca E, Luciano R, Torrioli G, Tortorolo G (2002) Controlled trial of early dexamethasone treatment for the prevention of chronic lung disease in preterm infants: a 3-year follow-up. Pediatrics 109: e85. 31. Rosenfeld M, Emerson J, Williams WJ, Pepe M, Smith A, Montgomery AB, Ramsey B (2001) Defining a pulmonary exacerbation in cystic fibrosis. The Journal of pediatrics 139: 359-365. 32. Rudorfer MV (1993) Challenges in medication clinical trials. Psychopharmacology Bulletin 29: 35-44. 33. Ruperto N, Giannini EH (1996) Redundancy of conventional articular response variables used in juvenile chronic arthritis clinical trials. Annals of the Rheumatic Diseases 55(1):73-5, 34. Schoenfeld DAP, Bernard GRM, for the ARDS Network (2002) Statistical evaluation of ventilator-free days as an efficacy measure in clinical trials of treatments for acute respiratory distress syndrome. [Article]. Critical Care Medicine 30: 1772-1777. 35. Schönbeck Y, Sanders EA, Hoes AW, Schilder AG, Verheij TJ, Hak E (2005) Rationale and design of the prevention of respiratory infections and management in children (PRIMAKid) study: a randomized controlled trial on the effectiveness and costs of combined influenza and pneumococcal vaccination in pre-school children with recurrent respiratory tract infections. Vaccine 23: 4906-4914. 36. Shapiro GG, DuHamel TR, Wighton TG, Chinn T, Warren Bierman C,et al (1999) The childhood asthma management program (CAMP): Design, rationale, and methods. Controlled Clinical Trials 20: 91-120. 37. Sharek PJ, Mayer ML, Loewy L, Robinson TN, Shames RS, Umetsu DT, Bergman DA (2002) Agreement Among Measures of Asthma Status: A Prospective Study of Low-Income Children With Moderate to Severe Asthma. Pediatrics 110: 797-804. 38. Spahn J (2003) Clinical trial efficacy: what does it really tell you?. [Review] [15 refs]. Journal of Allergy & Clinical Immunology 112(5 Suppl):S102-6, 39. Spencer AJ (1997) Skewed distributions--new outcome measures. [Review] [47 refs]. Community Dentistry & Oral Epidemiology 25(1):52-9, 40. Thase ME (1999) How should efficacy be evaluated in randomized clinical trials of treatments for depression?. [Review] [34 refs]. Journal of Clinical Psychiatry 60 Suppl 4:23-31; discussion 32, 41. Theander E, Andersson SI, Manthorpe R, Jacobsson LT (2005) Proposed core set of outcome measures in patients with primary Sjogren's syndrome: 5 year follow up. Journal of Rheumatology 32(8):1495-502, 42. Veldhuyzen van Zanten SJ, Chiba N, Armstrong D, Barkun AN et al (2006) Validation of a 7-point Global Overall Symptom scale to measure the severity of dyspepsia symptoms in clinical trials. Alimentary Pharmacology & Therapeutics 23(4):521-9, 43. Walsh MC, Wilson-Costello D, Zadell A, Newman N, Fanaroff A (2003) Safety, reliability, and validity of a physiologic definition of bronchopulmonary dysplasia. Journal of Perinatology 23(6):451-6, 44. Walsh MC, Yao Q, Gettner P, Hale E, Collins Met al (2004) Impact of a physiologic definition on bronchopulmonary dysplasia rates. Pediatrics 114: 1305-1311. 45. Zhang B, Schmidt B (2001) Do we measure the right end points? A systematic review of primary outcomes in recent neonatal randomized clinical trials. [Review] [16 refs]. Journal of Pediatrics 138(1):76-80, 46. Aurora P, Bush A, Gustafsson P, Oliver C, Wallis C et al (2005) MultipleBreath Washout as a Marker of Lung Disease in Preschool Children with Cystic Fibrosis. Am J Respir Crit Care Med 171: 249-256. 47. Brody AS, Klein JS, Molina PL, Quan J, Bean JA, Wilmott RW (2004) Highresolution computed tomography in young patients with cystic fibrosis: Distribution of abnormalities and correlation with pulmonary function tests. The Journal of Pediatrics 145: 32-38. 48. Joint LWPES/ESPE CAH Working Group (2002) Consensus Statement on 21Hydroxylase Deficiency from The Lawson Wilkins Pediatric Endocrine Society and The European Society for Paediatric Endocrinology. J Clin Endocrinol Metab 87: 4048-4053. 49. Clayton PE, Cuneo RC, Juul A, Monson JP, Shalet SM, Tauber M (2005) Consensus statement on the management of the GH-treated adolescent in the transition to adult care. Eur J Endocrinol 152: 165-170. 50. Dunger DB, Sperling MA, Acerini CL, Bohn DJ, Daneman D et al (2004) European Society for Paediatric Endocrinology/Lawson Wilkins Pediatric Endocrine Society Consensus Statement on Diabetic Ketoacidosis in Children and Adolescents. Pediatrics 113: e133-e140. 51. Hughes IA, Houk C, Ahmed SF, Lee PA, LWPES/ESPE Consensus Group (2006) Consensus statement on management of intersex disorders. Arch Dis Child 91: 554-563. 52. Lum S, Gustafsson P, Ljungberg H, Hulskamp G, Bush A et al (2007) Early detection of cystic fibrosis lung disease: multiple-breath washout versus raised volume tests. Thorax 62: 341-347. 53. Ordonez CL, Henig NR, Mayer-Hamblett N, Accurso FJ, Burns JL et al (2003) Inflammatory and Microbiologic Markers in Induced Sputum after Intravenous Antibiotics in Cystic Fibrosis. Am J Respir Crit Care Med 168: 1471-1475. 54. Ordonez CL, Kartashov AI, Wohl ME (2004) Variability of markers of inflammation and infection in induced sputum in children with cystic fibrosis. The Journal of Pediatrics 145: 689-692. 55. Ratjen F (2006) What's new in CF airway inflammation: An update. Paediatric Respiratory Reviews 7: S70-S72. 56. Ranjan S, Lindsay JM, Colin W, Christopher M, Janis KS, Andrew B (2003) Safety and use of sputum induction in children with cystic fibrosis. Pediatric Pulmonology 35: 309-313. 57. Whitehouse W, Silcocks P, Hodgson S, Choonara I (2007) Consumer involvement in paediatric trials: a step in the right direction with P3MC. Developmental Medicine & Child Neurology 49: 46-47.