{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:26:55Z","timestamp":1790735215496,"version":"4.1.0"},"reference-count":66,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T00:00:00Z","timestamp":1679011200000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,3,8]]},"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Consensus is lacking on the optimal management of asymptomatic congenital pulmonary airway malformation (CPAM). For future studies, the CONNECT consortium (the COllaborative Neonatal Network for the first European CPAM Trial)\u2014an international collaboration of specialised caregivers\u2014has established consensus on a core outcome set of outcome parameters concerning respiratory insufficiency, surgical complications, mass effect and multifocal disease. These outcome parameters have been incorporated in the CONNECT trial, a randomised controlled trial which, in order to develop evidence-based practice, aims to compare conservative and surgical management of patients with an asymptomatic CPAM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>Children are eligible for inclusion after the CPAM diagnosis has been confirmed on postnatal chest CT scan and they remain asymptomatic. On inclusion, children are randomised to receive either conservative or surgical management. Subsequently, children in both groups are enrolled into a standardised, 5-year follow-up programme with three visits, including a repeat chest CT scan at 2.5 years and a standardised exercise tolerance test at 5 years.<\/jats:p>\n                    <jats:p>The primary outcome is exercise tolerance at age 5 years, measured according to the Bruce treadmill protocol. Secondary outcome measures are molecular genetic diagnostics, validated questionnaires\u2014on parental anxiety, quality of life and healthcare consumption\u2014, repeated imaging and pulmonary morbidity during follow-up, as well as surgical complications and histopathology. This trial aims to end the continuous debate surrounding the optimal management of asymptomatic CPAM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study is being conducted in accordance with the Declaration of Helsinki. The Medical Ethics Review Board of Erasmus University Medical Centre Rotterdam, The Netherlands, has approved this protocol (MEC-2022\u20130441). Results will be disseminated through peer-reviewed scientific journals and conference presentations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05701514\">NCT05701514<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-071989","type":"journal-article","created":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T07:11:00Z","timestamp":1683097860000},"page":"e071989","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["COllaborative Neonatal Network for the first European CPAM Trial (CONNECT): a study protocol for a randomised controlled trial"],"prefix":"10.1136","volume":"13","clinical-trial-number":[{"clinical-trial-number":"nct05701514","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6514-086X","authenticated-orcid":false,"given":"Casper M","family":"Kersten","sequence":"first","affiliation":[{"name":"Paediatric Surgery, Erasmus MC Sophia Children's Hospital, Rotterdam, Zuid-Holland, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7296-9932","authenticated-orcid":false,"given":"Sergei M","family":"Hermelijn","sequence":"additional","affiliation":[{"name":"Paediatric Surgery, Erasmus MC Sophia Children's Hospital, Rotterdam, Zuid-Holland, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis W J","family":"Dossche","sequence":"additional","affiliation":[{"name":"Paediatric Surgery, Erasmus MC Sophia Children's Hospital, Rotterdam, Zuid-Holland, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagarajan","family":"Muthialu","sequence":"additional","affiliation":[{"name":"Tracheal Team, Department of Cardiothoracic Surgery, Great Ormond Street Hospital for Children, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D","family":"Losty","sequence":"additional","affiliation":[{"name":"Paediatric Surgery, Institute Of Life Course And Medical Sciences, University of Liverpool, Liverpool, UK"},{"name":"Paediatric Surgery, Ramathibodi Hospital Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"Schurink","sequence":"additional","affiliation":[{"name":"Paediatric Surgery, Radboud University Medical Centre Amalia Children\u2019s Hospital, Nijmegen, the Netherlands, Nijmegen, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 B","family":"Rietman","sequence":"additional","affiliation":[{"name":"Child and Adolescent Psychiatry, Erasmus MC Sophia Children Hospital, Rotterdam, Zuid-Holland, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marten J","family":"Poley","sequence":"additional","affiliation":[{"name":"Paediatric Surgery, Erasmus MC Sophia Children's Hospital, Rotterdam, Zuid-Holland, Netherlands"},{"name":"Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost","family":"van Rosmalen","sequence":"additional","affiliation":[{"name":"Biostatistics, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands"},{"name":"Epidemiology, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tabitha P L","family":"Zanen - 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