Research Article
Abstract
Background: There is a lack of up-to-date, systematic reviews that critically assess the role and potential limitations\r\nof Evidence based medicine (EBM) and systematic reviews in neonatology.\r\nMethods: We performed a systematic literature review of all Cochrane Reviews published between 1996 and 2010\r\nby the Cochrane Neonatal Review Group (CNRG). Main outcome parameter: Assessment of the percentage of reviews\r\nthat concluded that a certain intervention provides a benefit, percentage of reviews that concluded that no benefit was\r\nseen, and percentage of studies that concluded that the current level of evidence is inconclusive.\r\nResults: In total, 262 reviews were enrolled, most of which included exclusively preterm infants (146/262). The\r\nmajority of reviews assessed pharmacological interventions (145/262); other important fields included nutritional\r\n(46/262), and ventilatory issues (27/262). In 42/262 reviews a clear recommendation in favor of a certain interventions\r\nwas given, while 98/262 reviews concluded that certain interventions should not be performed. However, the largest\r\nproportion of reviews was inconclusive (122/262), and did not issue specific recommendations. The proportion of\r\ninconclusive reviews increased from 30% (1996-2000), to 50% (2001-2005), and finally to 58% for the years 2006-\r\n2010. Common reasons for inconclusive reviews were small number of patients (105), insufficient data (94), insufficient\r\nmethodological quality (87), and heterogeneity of studies (69).\r\nConclusions: There is an ongoing need for high quality research in order to reduce the proportion of inconclusive\r\nmeta-analyses in the field of neonatology. Funding and research agencies will play a vital role in selecting the most\r\nappropriate research programs.\r\n