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Erschienen in: Wiener Medizinische Wochenschrift 11-12/2017

02.03.2017 | original article

The role and limitations of Cochrane reviews at the bedside: a systematic synopsis of five pediatric subspecialties

verfasst von: Prof. Dr. med. Sascha Meyer, Martin Poryo, Sara Khosrawikatoli, Yvonne Goda, Michael Zemlin

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 11-12/2017

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Summary

Background

Cochrane meta-analyses provide the physician at the bedside with the most relevant, up-to-date clinical information. However, implementation of evidence-based medicine (EBM) at the bedside may be difficult for a variety of reasons. The aim of this study was to assess relevant issues and obstacles related to implementing EBM in pediatrics in real life at the bedside/cotside.

Methods

We performed five systematic literature reviews of all published Cochrane reviews in neonatology (1996–2010), pediatric neurology (1996–2010), pediatric gastroenterology (1993–2012), pediatric cardiology (2001–2015), and complementary and alternative medicine (1996–2012; CAM) in children and neonates. In all five analyses, the main outcome variables were percentage of reviews concluding that a certain intervention provides a benefit, percentage of reviews concluding that a certain intervention should not be performed, and percentage of studies concluding that the current level of evidence is inconclusive.

Results

In all five areas of pediatrics, a substantial number of Cochrane reviews yielded inconclusive data (neonatology: 46.6%; neuropediatrics: 26.8%; pediatric gastroenterology: 27.9%; pediatric cardiology: 42.9%; complementary and alternative medicine: 66.9%).

Conclusions

Our up-dated systematic synopsis reiterates the need for high-quality, sophisticated research to reduce the number of inconclusive meta-analyses in the field of pediatrics—most importantly in the field of complementary and alternative medicine (CAM), neonatology, and pediatric cardiology. The realization of high-quality, clinically driven research will in turn yield more systematic reviews with a clear conclusion (e. g., in favor or against a certain intervention, or treatment modality), thus, substantively decreasing the proportion of inconclusive reviews.
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Metadaten
Titel
The role and limitations of Cochrane reviews at the bedside: a systematic synopsis of five pediatric subspecialties
verfasst von
Prof. Dr. med. Sascha Meyer
Martin Poryo
Sara Khosrawikatoli
Yvonne Goda
Michael Zemlin
Publikationsdatum
02.03.2017
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 11-12/2017
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-017-0549-3

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