Comparative effectiveness of medical interventions in adults versus children
Φόρτωση...
Ημερομηνία
Συγγραφείς
Contopoulos-Ioannidis, D. G.
Baltogianni, M. S.
Ioannidis, J. P.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
J Pediatr
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
OBJECTIVE: To estimate the comparative effectiveness of medical interventions in adults versus children. STUDY DESIGN: We identified from the Cochrane Database of Systematic Reviews (Issue 1, 2007) meta-analyses with data on at least 1 adult and 1 pediatric randomized trial with binary primary efficacy outcome. For each meta-analysis, we calculated the summary odds ratio of the adult trials and the pediatric trials, respectively; the relative odds ratio (ROR) of the adult versus pediatric odds ratios per meta-analysis; and the summary ROR across all meta-analyses. ROR <1 means that the experimental intervention is more unfavorable in children than adults. RESULTS: Across 128 eligible meta-analyses (1051 adult and 343 pediatric trials), the summary ROR did not show a statistically significant difference between adults and children (0.96; 95% confidence intervals, 0.86 to 1.08). However, in all meta-analyses except for 1, the individual ROR's 95% confidence intervals could not exclude a relative difference in efficacy over 20%. In two-thirds, the relative difference in observed point estimates exceeded 50%. Nine statistically significant discrepancies were identified; 4 of them were also clinically important. CONCLUSIONS: Treatment effects are on average similar in adults and children, but available evidence leaves large uncertainty about their relative efficacy. Clinically important discrepancies may occur.
Περιγραφή
Λέξεις-κλειδιά
Adult, Age Factors, Child, Comparative Effectiveness Research, Health Services/*utilization, Humans, *Intervention Studies, Meta-Analysis as Topic, Odds Ratio, Outcome Assessment (Health Care), Randomized Controlled Trials as Topic, Research Design, Treatment Outcome
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/20434730
http://ac.els-cdn.com/S0022347610001216/1-s2.0-S0022347610001216-main.pdf?_tid=0566388665c78496f117829115288497&acdnat=1333363539_ecd96816a4fd3aae783d2d014f022a25
http://ac.els-cdn.com/S0022347610001216/1-s2.0-S0022347610001216-main.pdf?_tid=0566388665c78496f117829115288497&acdnat=1333363539_ecd96816a4fd3aae783d2d014f022a25
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής