Article type
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Abstract
Background: Children’s responses to health care interventions often differ significantly from those of adults. Consequently, systematic review (SR) authors must consider the physiological, developmental and psychosocial aspects of childhood. Guidance for SR authors in this area remains limited.
Key considerations: We identified resources to assist decision-making in the following areas: Population. A key decision at the outset of the review is whether to focus on child data only, or to include both adult and child data. This decision is often based on clinical expertise about the condition and its trajectory at different ages; care guidelines can also be used. Outcomes: The selection of a priori outcomes should be based on sound knowledge of the disease trajectory and children’s development. Relevant short-term outcomes may differ for children and adults, and similar outcomes may be assessed using different measurement tools. Recognition that the benefits and harms of treatment for children may unfold across subsequent decades of life may influence the choice of outcomes to be assessed and study designs to be included. Subgroups: Within the age range of 0-18 years, one can expect differing reactions to interventions. Authors should analyse age groups where there may be important similarities or differences in terms of physiological and psychosocial development. Searching: Databases have varying definitions of 'child’ and other age-based terms, and may be inconsistent in indexing pediatric material. The assistance of a librarian experienced with using pediatric-search filters will help to identify relevant material.
Conclusions: Key stages of carrying out SRs in children are affected by the dynamic nature of childhood. Authors are urged to carefully consider how children’s psychosocial and physiological development along the age span will influence their response to interventions. Work is under way to define the key developmental stages of childhood and how they intersect with different disease conditions.
Key considerations: We identified resources to assist decision-making in the following areas: Population. A key decision at the outset of the review is whether to focus on child data only, or to include both adult and child data. This decision is often based on clinical expertise about the condition and its trajectory at different ages; care guidelines can also be used. Outcomes: The selection of a priori outcomes should be based on sound knowledge of the disease trajectory and children’s development. Relevant short-term outcomes may differ for children and adults, and similar outcomes may be assessed using different measurement tools. Recognition that the benefits and harms of treatment for children may unfold across subsequent decades of life may influence the choice of outcomes to be assessed and study designs to be included. Subgroups: Within the age range of 0-18 years, one can expect differing reactions to interventions. Authors should analyse age groups where there may be important similarities or differences in terms of physiological and psychosocial development. Searching: Databases have varying definitions of 'child’ and other age-based terms, and may be inconsistent in indexing pediatric material. The assistance of a librarian experienced with using pediatric-search filters will help to identify relevant material.
Conclusions: Key stages of carrying out SRs in children are affected by the dynamic nature of childhood. Authors are urged to carefully consider how children’s psychosocial and physiological development along the age span will influence their response to interventions. Work is under way to define the key developmental stages of childhood and how they intersect with different disease conditions.