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ISSN: 2167-0897

Journal of Neonatal Biology
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Research Article

Systematic Cochrane Reviews in Neonatology: A Critical Appraisal

Christiane Willhelm1, Wolfgang Girisch1, Sven Gottschling2, Stefan Gräber4 and Sascha Meyer1, 3*
1Medical School, University of Saarland, Germany
2Department of Paediatric Palliative Care, University Children´s Hospital of Saarland, Germany
3Department of Paediatrics and Neonatology, University Children´s Hospital of Saarland, Germany
4Department of Biostatistics and Epidemiology, University Hospital of Saarland, Germany
Corresponding Author : Sascha Meyer
Department of Paediatrics and Neonatology
University Children´s Hospital of Saarland
Building 9, 66421 Homburg, Germany
Tel: +49 (0)6841-1628374
Fax: +49 (0)6841-1628363
E-mail: [email protected]
Received April 06, 2012; Accepted July 23, 2012; Published July 26, 2012
Citation: Willhelm C, Girisch W, Gottschling S, Gräber S, Meyer S (2012) Systematic Cochrane Reviews in Neonatology: A Critical Appraisal. J Neonatal Biol 1:106. doi:10.4172/2167-0897.1000106
Copyright: © 2012 Willhelm C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: There is a lack of up-to-date, systematic reviews that critically assess the role and potential limitations
of Evidence based medicine (EBM) and systematic reviews in neonatology.
Methods: We performed a systematic literature review of all Cochrane Reviews published between 1996 and 2010
by the Cochrane Neonatal Review Group (CNRG). Main outcome parameter: Assessment of the percentage of reviews
that concluded that a certain intervention provides a benefit, percentage of reviews that concluded that no benefit was
seen, and percentage of studies that concluded that the current level of evidence is inconclusive.
Results: In total, 262 reviews were enrolled, most of which included exclusively preterm infants (146/262). The
majority of reviews assessed pharmacological interventions (145/262); other important fields included nutritional
(46/262), and ventilatory issues (27/262). In 42/262 reviews a clear recommendation in favor of a certain interventions
was given, while 98/262 reviews concluded that certain interventions should not be performed. However, the largest
proportion of reviews was inconclusive (122/262), and did not issue specific recommendations. The proportion of
inconclusive reviews increased from 30% (1996-2000), to 50% (2001-2005), and finally to 58% for the years 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 an ongoing need for high quality research in order to reduce the proportion of inconclusive
meta-analyses in the field of neonatology. Funding and research agencies will play a vital role in selecting the most
appropriate research programs.

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