Table 2 Results for newborn and child health systematic review reports
Proportion (%) of “Yes” responses for the total (no.) of reviews eligible for scoring | |||||||||
|---|---|---|---|---|---|---|---|---|---|
Type of review | Intervention/exposure group | ||||||||
Itema number | Item | Overall (N = 248) | Cochrane (N = 100) | Non-Cochrane (N = 148) | p value | Children only (N = 151) | Children and adults (N = 64) | Family and maternal (N = 33) | p value |
Title | |||||||||
1) | Identify the report as a systematic review, meta-analysis, or both for pediatric population as a focus of review, if applicable | 62.1 (248) | 67 (100) | 58.8 (148) | 0.194 | 78.8 (151) | 26.6 (64) | 54.5 (33) | p < 0.01* |
Abstract | |||||||||
2) | Provide a structured summary including, as applicable, background; objectives; data sources; study eligibility criteria, including specifying targeted pediatric age group(s), interventions; primary and secondary outcomes; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number | 9.3 (248) | 16 (100) | 4.7 (148) | p < 0.01* | 12.6 (151) | 3.1 (64) | 6.1 (33) | 0.079 |
2a) | If a systematic review includes both adults and children, describe a subgroup analysis for the targeted pediatric age group(s) in the methods and results of the abstract | 11.6 (69) | 9.1 (33) | 13.9 (36) | 0.538 | NA | 11.3 (62) | 14.3 (7) | 0.815 |
2b) | Describe applicability or limits of applicability of the results of the systematic review to the targeted pediatric age group(s) | 62.1 (248) | 65 (100) | 60.1 (148) | 0.440 | 75.5 (151) | 35.9 (64) | 51.5 (33) | p < 0.01* |
Introduction | |||||||||
Rationale | |||||||||
3) | Describe the rationale for the review in the context of what is already known | ||||||||
3a) | In the contexts of the synthesized evidence in adults or other pediatric groups (non-targeted), explain the rationale for synthesizing evidence for the targeted pediatric age group(s). Provide hypotheses that relate to the targeted pediatric age group(s) | 3.6 (248) | 5 (100) | 2.7 (148) | 0.345 | 6 (151) | 0 (64) | 0 (33) | 0.066 |
Objectives | |||||||||
4) | Provide an explicit statement of questions being addressed with reference to targeted pediatric age groups, interventions, comparisons, outcomes, and study design (PICOS) | 0.8 (248) | 2 (100) | 0 (148) | 0.087 | 0.7 (151) | 1.6 (64) | 0 (33) | 0.703 |
Methods | |||||||||
Eligibility criteria | |||||||||
6) | Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale | ||||||||
6a) | Justify the targeted pediatric age group(s) selected | 74.2 (248) | 73 (100) | 75 (148) | 0.725 | 88.7 (151) | 34.4 (64) | 84.8 (33) | p < 0.01* |
6b) | Intervention: Justify the intervention for the targeted pediatric age group(s) addressing potential age-related differences in intervention effects | 67.7 (248) | 65 (100) | 69.6 (148) | 0.449 | 78.1 (151) | 32.8 (64) | 87.9 (33) | p < 0.01* |
6c) | Provide rationale for extrapolation or adaptation of adult intervention, if any | 29.6 (27) | 28.6 (7) | 30 (20) | 0.946 | 40 (20) | 0 (7) | 0 (0) | 0.037 |
6d) | Comparators: Explain the choice of comparator(s) and, if applicable, evidence for the active comparator and/or standard of care for targeted pediatric age group(s) | 9.7 (248) | 11 (100) | 8.8 (148) | 0.564 | 9.9 (151) | 7.8 (64) | 12.1 (33) | 0.759 |
6e) | Outcomes: List and define all the primary outcomes addressed for the targeted pediatric age group(s). List and define growth and development outcomes and adverse outcomes (events), if applicable | 41.1 (248) | 57 (100) | 30.4 (148) | p < 0.01* | 51.7 (151) | 10.9 (64) | 51.5 (33) | p < 0.01* |
6f) | Outcomes: Explain the clinical relevance of the selected outcomes (benefits and harms) for the targeted pediatric age group(s) | 34.3 (248) | 38 (100) | 31.8 (148) | 0.312 | 40.4 (151) | 20.3 (64) | 33.3 (33) | 0.018* |
6g) | Outcomes: Explain the validity, feasibility, and responsiveness of the outcome measures for the pre-targeted pediatric age group(s) | 0 (248) | 0 (100) | 0 (148) | p > .999 | 0 (151) | 0 (64) | 0 (33) | p > .999 |
Search | |||||||||
8) | Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated | ||||||||
8a) | Describe the search strategy and terms (including database specific MeSH terms for pediatric population) used to address the targeted pediatric age group(s) | 44 (248) | 38 (100) | 48 (148) | 0.124 | 60.3 (151) | 3.1 (64) | 48.5 (33) | p < 0.01* |
Summary measures | |||||||||
13) | State the principal summary measures (e.g., risk ratio, difference in means) | ||||||||
13a) | If data were available for adult and pediatrics, provide summary measures for adult and targeted pediatric age group(s) separately | 2.2 (89) | 2.1 (47) | 2.3 (42) | 0.950 | NA (NA) | 3.2 (63) | 0 (26) | p < 0.01* |
Synthesis of results | |||||||||
14) | Describe the methods of handling data and combining results of studies if done, including measures of consistency (e.g., I2) for each meta-analysis | ||||||||
14a) | For studies that included pediatrics and adults without a subgroup analysis of the pediatric population, describe how the data on targeted pediatric age group(s) were used in the analysis | 0 (89) | 0 (47) | 0 (42) | p > .999 | NA (NA) | 0 (63) | 0 (26) | p > .999 |
Additional analyses | |||||||||
16) | Describe methods of additional analyses (e.g., sensitivity or subgroup analyses for targeted pediatric age group(s), meta-regression), if done, indicating which were pre-specified | 54.9 (142) | 64.1 (92) | 38 (50) | p < 0.01* | 54.1 (74) | 68.9 (45) | 30.4 (23) | p < 0.01* |
Results | |||||||||
Study characteristics | |||||||||
18) | For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations | ||||||||
18a) | Provide sample size of pediatric group and subgroups (if applicable) for each study. | 72.6 (234) | 74.2 (89) | 71.7 (145) | 0.686 | 83.6 (146) | 42.6 (61) | 81.5 (27) | p < 0.01* |
Synthesis of results | |||||||||
21) | Present results of each meta-analysis done, including confidence intervals and measures of consistency. | ||||||||
21a) | Report the numbers of included studies with pediatric participants. Where applicable, report the number of events and total pediatric population on which the result synthesis is based | 60.7 (168) | 70.5 (78) | 52.2 (90) | 0.018* | 79 (100) | 20.4 (49) | 68.4 (19) | p < 0.01* |
Additional analysis | |||||||||
23) | Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses for the targeted pediatric age group(s), meta-regression [see Item 16]) | 54.0 (87) | 65.1 (43) | 43.2 (44) | 0.046* | 53.2 (47) | 58.1 (31) | 44.4 (9) | 0.743 |
Discussion | |||||||||
Summary of evidence | |||||||||
24) | Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, i.e., children, carer such as parents or legal guardians, and policy makers). | 74.5 (239) | 70.7 (92) | 76.9 (147) | 0.286 | 83.8 (148) | 48.4 (62) | 82.8 (29) | p < 0.01* |
Limitations | |||||||||
25) | Discuss limitations at study and outcome level (e.g., risk of bias, growth and developmental outcomes in children, and minimally important differences in children) at targeted pediatric age group(s) level (e.g., newborn and infant under 5 years), and at review level (e.g., incomplete retrieval of identified research, reporting bias and paucity of research in children) | 35.8 (232) | 29.4 (85) | 39.5 (147) | 0.128 | 46.9 (145) | 16.4 (61) | 19.2 (26) | p < 0.01* |
Conclusions | |||||||||
26) | Provide a general interpretation of the results in the context of other evidence (e.g., evidence from adult studies and pre-clinical studies). Implications for future research in practice, or policy related to the targeted pediatric age group(s) | 43.9 (244) | 45.8 (96) | 42.6 (148) | 0.624 | 52.7 (150) | 17.5 (63) | 54.8 (31) | p < 0.01* |
Funding | |||||||||
27) | Describe sources of funding for the systematic review and other support (e.g., supply of data) and role of funders for the systematic review | ||||||||
27a) | For each included trial in a systematic review, indicate (a plan to include) the source of financial support (such as government, academia or industry), if any, in the trial(s) | 5.6 (248) | 8 (100) | 4.1 (148) | 0.190 | 4 (151) | 10.9 (64) | 3 (33) | 0.113 |