Pediatrics · 2017
Variations in Definitions and Outcome Measures in Gastroesophageal Reflux Disease: A Systematic Review.
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Singendonk Maartje M J, Brink Anna J, Steutel Nina F, van Etten-Jamaludin Faridi S, van Wijk Michiel P, Benninga Marc A, Tabbers Merit M
Аннотация
CONTEXT: Gastroesophageal reflux (GER) is defined as GER disease (GERD) when it leads to troublesome symptoms and/or complications. We hypothesized that definitions and outcome measures in randomized controlled trials (RCTs) on pediatric GERD would be heterogeneous.
OBJECTIVES: Systematically assess definitions and outcome measures in RCTs in this population.
DATA SOURCES: Data were obtained through Cochrane, Embase, Medline, and Pubmed databases.
STUDY SELECTION: We selected English-written therapeutic RCTs concerning GERD in children 0 to 18 years old.
DATA EXTRACTION: Data were tabulated and presented descriptively. Each individual parameter or set of parameters with unique criteria for interpretation was considered a single definition for GER(D). Quality was assessed by using the Delphi score.
RESULTS: A total of 2410 unique articles were found; 46 articles were included. Twenty-six (57%) studies defined GER by using 25 different definitions and investigated 25 different interventions. GERD was defined in 21 (46%) studies, all using a unique definition and investigating a total of 23 interventions. Respectively 87 and 61 different primary outcome measures were reported by the studies in GER and GERD. Eight (17%) studies did not report on side effects. Of the remaining 38 (83%) studies that did report on side effects, 18 (47%) included this as predefined outcome measure of which 4 (22%) as a primary outcome measure. Sixteen studies (35%) were of good methodological quality.
LIMITATIONS: Only English-written studies were included.
CONCLUSIONS: Inconsistency and heterogeneity exist in definitions and outcome measures used in RCTs on pediatric GER and GERD; therefore, we recommend the development of a core outcome set.
OBJECTIVES: Systematically assess definitions and outcome measures in RCTs in this population.
DATA SOURCES: Data were obtained through Cochrane, Embase, Medline, and Pubmed databases.
STUDY SELECTION: We selected English-written therapeutic RCTs concerning GERD in children 0 to 18 years old.
DATA EXTRACTION: Data were tabulated and presented descriptively. Each individual parameter or set of parameters with unique criteria for interpretation was considered a single definition for GER(D). Quality was assessed by using the Delphi score.
RESULTS: A total of 2410 unique articles were found; 46 articles were included. Twenty-six (57%) studies defined GER by using 25 different definitions and investigated 25 different interventions. GERD was defined in 21 (46%) studies, all using a unique definition and investigating a total of 23 interventions. Respectively 87 and 61 different primary outcome measures were reported by the studies in GER and GERD. Eight (17%) studies did not report on side effects. Of the remaining 38 (83%) studies that did report on side effects, 18 (47%) included this as predefined outcome measure of which 4 (22%) as a primary outcome measure. Sixteen studies (35%) were of good methodological quality.
LIMITATIONS: Only English-written studies were included.
CONCLUSIONS: Inconsistency and heterogeneity exist in definitions and outcome measures used in RCTs on pediatric GER and GERD; therefore, we recommend the development of a core outcome set.