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Research Into Childhood Obstructive Sleep-Disordered Breathing: A Systematic Review
Roderick P Venekamp1, Deepak Chandrasekharan2, Francois Abel3
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Insights
Research on childhood obstructive sleep-disordered breathing (oSDB) has increased, but gaps remain in health services and economics research. Further studies are needed to improve care guidelines for pediatric oSDB.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Medicine
- Health Services Research
Background:
- Clinical guidelines for childhood obstructive sleep-disordered breathing (oSDB) are debated.
- The optimal care pathway for pediatric oSDB requires further evidence.
- A comprehensive understanding of the research landscape is needed to guide future studies.
Purpose of the Study:
- To systematically review and map existing research on childhood oSDB.
- To identify evidence gaps in the field of pediatric oSDB.
- To support the development of future clinical guidelines and research agendas.
Main Methods:
- Systematic literature search of PubMed, EMBASE, and Cochrane Library up to November 2015.
- Inclusion of all publication types and languages related to childhood oSDB.
- Analysis of publication trends, research themes, and methodologies, with a focus on post-2011 publications.
Main Results:
- Over 5,800 publications on childhood oSDB were included, with 46% published since 2011.
- Most research (61%) focused on treatments, incidence, or prognosis.
- Limited research (2.7%) addressed health services, outcomes, or economics, with observational studies dominating (78.5%).
Conclusions:
- Recent research has expanded the knowledge base for childhood oSDB.
- A significant lack of research in health services, economics, and outcomes hinders the application of current evidence.
- Future research should prioritize these under-explored areas to inform clinical practice and guidelines.
Background:
Despite recent clinical guideline development, the best pathway of care for children with symptoms of obstructive sleep-disordered breathing (oSDB) is still debated. This systematic review aims to map the research in childhood oSDB that has been conducted so far to support further guideline development, identify evidence gaps, and guide future research.
Methods:
A systematic search was performed in PubMed, EMBASE, and the Cochrane Library from inception to November 26, 2015. All publications on childhood oSDB were included, irrespective of type and language. The annual number of publications in the field of oSDB was counted over all years; for those published since January 1, 2011 (ie, the date of the latest literature search of the American Academy of Pediatrics guideline), total and annual numbers of publications across main research themes and methodologies were calculated.
Results:
Of the 7,637 unique records retrieved, 5,871 publications were eligible for inclusion. There was an increase in annual publications since 2000, with 46% published since 2011. Most publications (61%) focused on individual treatment modalities, incidence, or prognosis. Few publications (2.7%) focused on health service delivery, outcomes, and health economics. Observational studies composed 78.5% of publications, 2.4% were randomized controlled trials, and 0.4% used a qualitative approach as their main methodology.
Conclusions:
A recent surge in research activity into childhood oSDB has improved the knowledge base for this condition; however, the lack of health services, health economics, and outcomes research impacts the applicability of evidence informing current guidance and leaves important questions for future research.
Registration:
PROSPERO: registration number CRD42015029291.
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