TY - JOUR
T1 - Co-occurring medical conditions in adults with Down syndrome
T2 - A systematic review toward the development of health care guidelines. Part II
AU - Capone, George
AU - Stephens, Mary
AU - Santoro, Stephanie
AU - Chicoine, Brian
AU - Bulova, Peter
AU - Peterson, Moya
AU - Jasien, Joan
AU - Smith, Anna Jo
N1 - Funding Information:
The DSMIG‐USA Adult Workgroup is grateful for the support in‐kind provided by the National Down Syndrome Congress for its Annual Symposium and Workgroup activities. No financial support was provided or received by DSMIG‐USA for the purpose of conducting this study.
Publisher Copyright:
© 2020 Wiley Periodicals, Inc.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Adults with Down syndrome (DS) represent a unique population who are in need of clinical guidelines to address their medical care. Many of these conditions are of public health importance with the potential to develop screening recommendations to improve clinical care for this population. Our workgroup previously identified and prioritized co-occurring medical conditions in adults with DS. In this study, we again performed detailed literature searches on an additional six medical conditions of clinical importance. A series of key questions (KQ) were formulated a priori to guide the literature search strategy. Our KQs focused on disease prevalence, severity, risk-factors, methodologies for screening/evaluation, impact on morbidity, and potential costs/benefits. The available evidence was extracted, evaluated and graded on quality. The number of participants and the design of clinical studies varied by condition and were often inadequate for answering most of the KQ. Based upon our review, we provide a summary of the findings on hip dysplasia, menopause, acquired cardiac valve disease, type 2 diabetes mellitus, hematologic disorders, and dysphagia. Minimal evidence demonstrates significant gaps in our clinical knowledge that compromises clinical decision-making and management of these medically complex individuals. The creation of evidence-based clinical guidance for this population will not be possible until these gaps are addressed.
AB - Adults with Down syndrome (DS) represent a unique population who are in need of clinical guidelines to address their medical care. Many of these conditions are of public health importance with the potential to develop screening recommendations to improve clinical care for this population. Our workgroup previously identified and prioritized co-occurring medical conditions in adults with DS. In this study, we again performed detailed literature searches on an additional six medical conditions of clinical importance. A series of key questions (KQ) were formulated a priori to guide the literature search strategy. Our KQs focused on disease prevalence, severity, risk-factors, methodologies for screening/evaluation, impact on morbidity, and potential costs/benefits. The available evidence was extracted, evaluated and graded on quality. The number of participants and the design of clinical studies varied by condition and were often inadequate for answering most of the KQ. Based upon our review, we provide a summary of the findings on hip dysplasia, menopause, acquired cardiac valve disease, type 2 diabetes mellitus, hematologic disorders, and dysphagia. Minimal evidence demonstrates significant gaps in our clinical knowledge that compromises clinical decision-making and management of these medically complex individuals. The creation of evidence-based clinical guidance for this population will not be possible until these gaps are addressed.
KW - Down syndrome
KW - adult health conditions
KW - clinical practice guidelines
KW - evidence-based medicine
KW - literature review
KW - trisomy 21
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U2 - 10.1002/ajmg.a.61604
DO - 10.1002/ajmg.a.61604
M3 - Review article
C2 - 32338447
AN - SCOPUS:85084130838
SN - 1552-4825
VL - 182
SP - 1832
EP - 1845
JO - American Journal of Medical Genetics, Part A
JF - American Journal of Medical Genetics, Part A
IS - 7
ER -