A descriptive analysis of non-Cochrane child-relevant systematic reviews published in 2014

ID: 

362

Session: 

Poster session 3

Date: 

Tuesday 18 September 2018 - 12:30 to 14:00

All authors in correct order:

Gates M1, Elliott SA2, Johnson C1, Thomson D2, Williams K3, Fernandes RM4, Hartling L2
1 Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Canada
2 Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Cochrane Child Health, Canada
3 School of Pediatrics, Royal Children’s Hospital, Cochrane Child Health, Australia
4 Department of Pediatrics, Santa Maria Hospital, Lisbon Academic Center, Clinical Pharmacology and Therapeutics, Instituto de Medicina Molecular, Universidade de Lisboa; Cochrane Child Health, Portugal
Presenting author and contact person

Presenting author:

Lisa Hartling

Contact person:

Lisa Hartling
Abstract text
Background:
Consumers, clinicians, policymakers and researchers require high quality evidence to guide decision making in child health. Though Cochrane systematic reviews (SRs) are a well-established source of evidence, little is known about the characteristics of non-Cochrane child-relevant SRs.

Objectives:
To complement published descriptions of Cochrane SRs, we aimed to characterize the epidemiologic, methodological, and reporting qualities of all non-Cochrane child-relevant SRs published in 2014.

Methods:
All English-language child-relevant SRs of quantitative research that were not published in the Cochrane Library in 2014 were eligible for this descriptive analysis. We searched four online databases in August 2015. A single reviewer screened articles for inclusion; a second verified the excluded studies. Reviewers extracted: general characteristics of the review; included study characteristics; methodological approaches. We present findings narratively.

Results:
We identified 1598 child-relevant SRs containing a median (interquartile range (IQR)) 19 (11 to 33) studies. These originated primarily from high-income countries (n = 1247, 78.0%) and spanned 47 of the 53 Cochrane Review Groups. Most synthesized therapeutic (n = 753, 47.1%) or epidemiologic (n = 701, 43.8%) evidence. Though 39.3% (n = 628) of SRs included evidence specific to children only, few were published in pediatric-specific journals (n = 283, 17.7%). Reporting quality was poor overall; few reviews mentioned an a priori protocol (n = 246, 15.4%) or registration (n = 111, 6.9%), and only 23.4% (n = 374) specified a primary outcome. Many SRs relied solely on evidence from non-RCTs (n = 796, 49.8%). Less than two-thirds (n = 953, 59.6%) appraised the quality of included studies and assessments of the certainty of the body of evidence were rare (n = 102, 6.4%).

Conclusions:
Child-relevant Cochrane SRs are a known source of high-quality evidence in pediatrics. There exists, however, a wealth of evidence from non-Cochrane SRs that may be complementary. Our findings show that high-quality non-Cochrane SRs may not be practical nor easy for knowledge users to find. Improvements are needed to ensure that evidence syntheses published outside the Cochrane Library adhere to the high standard of conduct and reporting characteristic of Cochrane SRs.

Patient or healthcare consumer involvement:
None.

Relevance to patients and consumers: 

Knowledge users require high quality pediatric-specific evidence to guide decision-making in child health. Though the Cochrane Library remains the go-to source for high quality SRs, knowledge users may search elsewhere for evidence syntheses that suit their needs. We have shown that non-Cochrane evidence syntheses may complement those within the Cochrane Library, but that finding high quality non-Cochrane SRs may not be easy nor practical. Improvement is needed to ensure that all knowledge users (including patients and consumers) have easy access to high quality evidence syntheses outside of the Cochrane Library.