The role of Cochrane reviews in child neurology: A systematic analysis

Aims: Evidence based medicine (EBM) in the field of child neurology is considered an important contributor in providing the best quality of care. However, there is a lack of systematic analysis that assesses the role and potential limitations of EBM.

Methods: We performed a systematic literature review of all Cochrane Reviews published between 1996 and 2010 in paediatric neurology. Main outcome variables: Percentage of reviews that concluded that a certain intervention provides a benefit, percentage of reviews that concluded that a certain intervention should not be performed, and percentage of studies that concluded that the current level of evidence is inconclusive.

Results: In total, 112 reviews were enrolled; only 17 reviews included exclusively children. In 33/112 of reviews, a clear recommendation in favour of a certain intervention was given, 11/112 issued a conditional positive recommendation, while 32/112 reviews concluded that certain interventions should not be performed. Six reviews concluded that no differences were seen between different therapeutic/treatment options. Thirty reviews were inconclusive. The proportion of inconclusive reviews increased during 3, a priori defined time intervals. Common criticisms with regard to quality of enrolled studies included heterogeneous study populations (49/112), small number of study participants (48/112), and lack of comparability of studies (40/112).

Conclusion: EBM plays a key role in providing current and systematic data analysis in the field of child neurology. There is an ongoing need for high quality research in order to reduce the proportion of inconclusive meta-analysis. Further RCTs should include only paediatric populations.

Evidence based medicine - Cochrane Reviews - Neuropaediatrics