Zeitschrift für Neonatalbiologie

Abstrakt

Systematic Cochrane Reviews in Neonatology: A Critical Assessment

Background: There is a lack of recent, systematic reviews that
critically appraise the role and potential limitations of evidence-based medicine (EBM) and systematic reviews in neonatology.
Methods: We conducted a systematic literature search of all
Cochrane Reviews published by the Cochrane Neonatal Review Group (CNRG) between 1996 and 2010. Main outcome measures: Assessing the percentage of reviews
concluding that a particular intervention provides benefit, the percentage of reviews concluding that no benefit
was found, and the percentage of studies concluding that the current level of evidence is inconclusive.
Results: A total of 262 reviews were included, most of which included exclusively preterm infants (146/262). The
majority of reviews assessed pharmacological interventions (145/262); other key areas included feeding
(46/262) and ventilation issues (27/262). 42/262 reviews
made a clear recommendation for certain interventions, while 98/262 reviews concluded that certain interventions should not be performed.
However, the majority of reviews were inconclusive (122/262) and did not contain specific recommendations. The proportion of
inconclusive reviews increased from 30% (1996–2000) to 50% (2001–2005) and finally to 58% in the period 2006–2010
. Common reasons for inconclusive reviews were small number of patients (105), insufficient data (94), insufficient
methodological quality (87) and heterogeneity of studies (69).
Conclusions: There is a continued need for qualitative research to reduce the proportion of inconclusive meta-analyses in the field of neonatology. Funding and research agencies will play a critical role
in selecting the most appropriate research programs.