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2016 ; 11
(3
): e0150864
Nephropedia Template TP
gab.com Text
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English Wikipedia
What Evidence Underlies Clinical Practice in Paediatric Surgery? A Systematic
Review Assessing Choice of Study Design
#MMPMID26959824
Allin B
; Aveyard N
; Campion-Smith T
; Floyd E
; Kimpton J
; Swarbrick K
; Williams E
; Knight M
PLoS One
2016[]; 11
(3
): e0150864
PMID26959824
show ga
OBJECTIVE: Identify every paediatric surgical article published in 1998 and every
paediatric surgical article published in 2013, and determine which study designs
were used and whether they were appropriate for robustly assessing interventions
in surgical conditions. METHODS: A systematic review was conducted according to a
pre-specified protocol (CRD42014007629), using EMBASE and Medline. Non-English
language studies were excluded. Studies were included if meeting population
criteria and either condition or intervention criteria. POPULATION: Children
under the age of 18, or adults who underwent intervention for a condition managed
by paediatric surgeons when they were under 18 years of age. CONDITION: One
managed by general paediatric surgeons. INTERVENTION: Used for treatment of a
condition managed by general paediatric surgeons. MAIN OUTCOME MEASURE: Studies
were classified according to whether the IDEAL collaboration recommended their
design for assessing surgical interventions or not. Change in proportions between
1998 and 2013 was calculated. RESULTS: 1581 paediatric surgical articles were
published in 1998, and 3453 in 2013. The most commonly used design, accounting
for 45% of studies in 1998 and 46.8% in 2013, was the retrospective case series.
Only 1.8% of studies were RCTs in 1998, and 1.9% in 2013. Overall, in 1998, 9.8%
of studies used a recommended design. In 2013, 11.9% used a recommended design
(proportion increase 2.3%, 95% confidence interval 0.5% increase to 4% increase,
p = 0.017). CONCLUSIONS AND RELEVANCE: A low proportion of published paediatric
surgical manuscripts utilise a design that is recommended for assessing surgical
interventions. RCTs represent fewer than 1 in 50 studies. In 2013, 88.1% of
studies used a less robust design, suggesting the need for a new way of
approaching paediatric surgical research.