Doak C, Heitmann B L, Summerbell C, Lissner L
Department of Nutrition and Health, Institute of Health Sciences, VU University, Amsterdam, The Netherlands.
Obes Rev. 2009 May;10(3):350-6. doi: 10.1111/j.1467-789X.2008.00550.x. Epub 2009 Jan 16.
Two reviews, one by Summerbell et al. and the other by Doak et al. came to very different conclusions about the effectiveness of childhood obesity interventions. The aim of this commentary is to assess the extent to which inclusion and exclusion criteria, and the definition of effective outcomes, explain discrepant results. Differences in results were compared by inclusion criteria and outcome definitions. The most important summary recommendations for inclusion/exclusion criteria were to exclude all non-peer review articles, to maintain a 6-month lower limit for duration of study, to include interventions from before 1990, to include pre-school age groups, to include pilot studies and to intervene in high-risk communities. Authors did not reach consensus regarding inclusion of aims not specific to preventing weight gain and the manner of assessment of anthropometric measures. Combining both reviews and applying agreed exclusion criteria leaves 30 interventions; 50% are positive. Excluding studies without an aim specific to preventing weight gain leaves 10/24 (42%) positive interventions. The differences in the results of these two reviews relate to the inclusion criteria and outcome assessments. These findings underscore the importance of the evidence considered in assessing interventions.
两项综述，一项由萨默贝尔等人撰写，另一项由多克等人撰写，对于儿童肥胖干预措施的有效性得出了截然不同的结论。本评论的目的是评估纳入和排除标准以及有效结果的定义在多大程度上解释了这些相互矛盾的结果。通过纳入标准和结果定义对结果差异进行了比较。关于纳入/排除标准的最重要总结建议是排除所有非同行评审文章，将研究持续时间的下限维持在6个月，纳入1990年以前的干预措施，纳入学龄前年龄组，纳入试点研究，并对高风险社区进行干预。作者们在是否纳入并非专门针对预防体重增加的目标以及人体测量指标的评估方式上未达成共识。将两项综述结合起来并应用商定的排除标准后，剩下30项干预措施；其中50%是有效的。排除那些并非专门针对预防体重增加目标的研究后，有10/24（42%）的干预措施是有效的。这两项综述结果的差异与纳入标准和结果评估有关。这些发现强调了评估干预措施时所考虑证据的重要性。
