{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T09:03:08Z","timestamp":1788080588076,"version":"build-2784847793"},"reference-count":53,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T00:00:00Z","timestamp":1604534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001279","name":"Great Ormond Street Hospital Charity","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001279","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Running randomized clinical trials (RCT) in fetal therapy is challenging. This is no different for fetoscopic endoluminal tracheal occlusion (FETO) for severe left\u2010sided Congenital Diaphragmatic Hernia (CDH). We assessed the knowledge, attitude and practice (KAP) of maternal\u2010fetal medicine specialists toward the antenatal management of CDH, and the randomized controlled clinical (RCT) \u201cTracheal Occlusion To Accelerate Lung growth\u2010trial.\u201d<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional KAP\u2010survey was conducted among 311 registrants of the 18th World Congress in Fetal Medicine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall knowledge of CDH and FETO was high. Remarkably only 45% considers prenatal prediction of neonatal outcome reliable. Despite, in their clinical practice they perform severity assessment (80%) and refer families for FETO either within the context of an RCT (43%) or on patient request (32%). Seventy percent perceives <jats:italic>not<\/jats:italic> offering FETO on patient demand seems as if no treatment is provided to a fetus with predicted poor outcome. Only 20% of respondents considers denying access to FETO on patient demand not as a psychological burden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Often the views of individual respondents contradicted with their clinical practice. It seems that, for severe CDH, clinicians face personal and practical dilemmas that undermine equipoise. To us, this indicates the tension between the clinical and scientific obligations physicians experience.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.5849","type":"journal-article","created":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T18:10:55Z","timestamp":1603131055000},"page":"179-189","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The <scp>TOTAL<\/scp> trial dilemma: A survey among professionals on equipoise regarding fetal therapy for severe congenital diaphragmatic hernia"],"prefix":"10.1002","volume":"41","author":[{"given":"Simen","family":"Vergote","sequence":"first","affiliation":[{"name":"Department of Development and Regeneration cluster Woman and Child, Biomedical Sciences KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Pizzolato","sequence":"additional","affiliation":[{"name":"Centre for Biomedical Ethics and Law KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration cluster Woman and Child, Biomedical Sciences KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kris","family":"Dierickx","sequence":"additional","affiliation":[{"name":"Centre for Biomedical Ethics and Law KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4920-945X","authenticated-orcid":false,"given":"Jan","family":"Deprest","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration cluster Woman and Child, Biomedical Sciences KU Leuven  Leuven Belgium"},{"name":"Institute of Women's Health University College of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6808-0874","authenticated-orcid":false,"given":"Neeltje","family":"Crombag","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration cluster Woman and Child, Biomedical Sciences KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60992-7"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61446-4"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2017.04.011"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2018.04.008"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3863"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5297"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2017.11.002"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4052"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1711"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000314617"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6141"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001675"},{"issue":"11","key":"e_1_2_10_14_1","first-page":"CD008925","article-title":"Prenatal interventions for congenital diaphragmatic hernia for improving outcomes","volume":"27","author":"Grivell RM","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_15_1","unstructured":"TOTAL\u2010trial [Internet].www.TOTALtrial.eu. 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