新生儿通风元分析中的盲目评估:一个系统的元流行病学审查
Ilari Kuitunen1,2, Kati Räsänen1,2, Maria Rosaria Gualano3
1University of Eastern Finland, Institute of Clinical Medicine and Department of Pediatrics, Kuopio, Finland.
Neonatology
|June 11, 2024
概括
在新生儿通风试验中的失明通常被高估. 像死亡率和支气管肺功能障碍 (BPD) 这样的客观结果不需要盲目进行准确的评估,防止不必要地降低证据确定性.
科学领域:
- 新生儿研究新生儿研究
- 临床试验方法论 临床试验方法论
- 基于证据的医学是基于证据的医学.
背景情况:
- 失明是随机试验中的关键因素,但其在新生儿通风研究中的可行性是可疑的.
- 在新生儿学中盲目的重要性可能被高估了,忽视了患者特定的因素和结果.
研究的目的:
- 调查新生儿通风试验的元分析中对失明的评估.
- 评估盲目评估对证据确定性评级的影响.
主要方法:
- 在过去5年中发表的元分析的元流行病学综述,重点关注新生儿通风及其结果 (死亡率,支气管肺功能障碍症).
- 在2023年11月搜索了PubMed和Scopus数据库.
- 使用GRADE标准,提取了关于偏见评估风险,特别是盲目的风险和证据确定性的数据.
主要成果:
- 在包括的40个元分析中,只有13个正确评估了失明.
- 使用偏差风险2.0 (RoB 2.0) 工具与正确的盲目评估 (Beta 0.57) 有显著的关联.
- 正确评估失明的审查不太可能不适当地降低证据确定性.
结论:
- 在新生儿证据合成中盲目的作用被高估了,导致证据确定性的不合理降级.
- 客观的结果,如死亡率和支气管肺功能障碍症,不受结果评估中缺乏盲目的影响.
- 未来的新生儿研究应该专注于适当的偏见风险工具,并在评估证据确定性时考虑结果的性质.
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