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

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

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.