Steutel Nina F, Benninga Marc A, Langendam Miranda W, de Kruijff Ineke, Tabbers Merit M
*Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center †Dutch Cochrane Centre, Academic Medical Center, University of Amsterdam, Amsterdam ‡Department of Pediatrics, Zuwe Hofpoort Ziekenhuis, Woerden, The Netherlands.
J Pediatr Gastroenterol Nutr. 2014 Sep;59(3):341-6. doi: 10.1097/MPG.0000000000000412.
Infant colic (IC), with an estimated prevalence of 5% to 25%, has a high impact on health care costs. Furthermore, reported negative sequelae are disturbed parent-infant interaction, increased susceptibility to abdominal pain, and even child abuse. Its etiology remains unknown, leading to a wide variety in interventions. We hypothesize that definitions and outcome measures in studies on IC will be heterogeneous as well. Our objective is to systematically assess how definitions and outcome measures are reported in randomized controlled trials (RCTs) of IC.
CENTRAL, Embase, and MEDLINE/PubMed were searched from inception to December 2012. English-language systematic reviews (SRs) and RCTs concerning IC in children ages 0 to 9 months were included. Bibliographies of included SRs were searched for additional articles. Quality was assessed using the Delphi list.
A total of 1702 studies were found; 55 articles were included (16 SRs, 39 RCTs). In 39 trials, we found 20 different definitions for IC, 11 different definitions for improvement, 28 different interventions, and 19 different outcomes. Fifty-one percent of the trials were of good methodological quality. All of the trials used parental diaries; only 31% stated that their instrument was validated.
Too many different definitions and outcome measures for IC are used in RCTs. Only a minority of the trials reported parental perception as primary outcome. Uniform definitions, outcomes, and validated instruments are needed to make a comparison between intervention studies possible.
婴儿腹绞痛(IC)的估计患病率为5%至25%,对医疗保健成本有很大影响。此外,据报道的负面后果包括亲子互动受扰、腹痛易感性增加,甚至虐待儿童。其病因仍然不明,导致干预措施多种多样。我们推测,关于IC的研究中的定义和结局指标也会存在异质性。我们的目的是系统评估IC随机对照试验(RCT)中如何报告定义和结局指标。
检索CENTRAL、Embase和MEDLINE/PubMed数据库,时间从建库至2012年12月。纳入关于0至9个月儿童IC的英文系统评价(SR)和RCT。检索纳入SR的参考文献以获取其他文章。使用德尔菲清单评估质量。
共检索到1702项研究;纳入55篇文章(16篇SR,39篇RCT)。在39项试验中,我们发现IC有20种不同定义,改善有11种不同定义,干预措施有28种不同类型,结局有19种不同类型。51%的试验方法学质量良好。所有试验均使用家长日记;只有31%表明其工具经过验证。
RCT中使用了太多不同的IC定义和结局指标。只有少数试验将家长的看法作为主要结局报告。需要统一的定义、结局指标和经过验证的工具,以便能够对干预研究进行比较。