Pediatric Residency and
Pediatric Residency and.
Pediatrics. 2021 Feb;147(2). doi: 10.1542/peds.2020-016162.
A common reproach precluding the use of osteopathic manipulative medicine (OMM) in pediatrics is a lack of evidence regarding its safety, feasibility, and effectiveness.
We conducted a systematic, scoping review of pediatric osteopathic medicine to identify gaps in the literature and make recommendations for future research.
We searched 10 databases using 6 key words and medical subject heading terms for any primary articles reporting OMM use in children published from database inception until initiation of the study.
Articles were selected if they reported primary data on OMM conducted in the United States on patient(s) 0 to 18 years old.
Baseline study characteristics were collected from each article and the Grading of Recommendations, Assessment, Development, and Evaluations system was used to critically appraise each study.
Database search yielded 315 unique articles with 30 studies fulfilling inclusion and exclusion criteria. Of these, 13 reported the data required to demonstrate statistically significant results, and no significant adverse events were reported. The majority of studies were graded as providing weak clinical evidence because of significant methodologic flaws and biases.
The review was limited to US-based studies and reports. Minimal discrepancies between reviewers were resolved via an objective third reviewer.
There is little strong, scientific, evidence-based literature demonstrating the therapeutic benefit of OMM for pediatric care. No strong clinical recommendations can be made, but it can be medically tolerated given its low risk profile. High-quality, scientifically rigorous OMM research is required to evaluate safety, feasibility, and efficacy in pediatrics.
阻碍小儿骨病手法医学（OMM）使用的一个常见指责是缺乏关于其安全性、可行性和有效性的证据。
我们对小儿骨病医学进行了系统的、范围界定的综述，以确定文献中的空白，并为未来的研究提出建议。
我们使用 6 个关键词和医学主题词在 10 个数据库中进行了搜索，以查找自数据库创建以来至研究启动时发表的任何报告儿童 OMM 使用情况的原始文章。
如果文章报告了在美国对 0 至 18 岁患者进行的 OMM 的原始数据，则选择该文章。
从每篇文章中收集基线研究特征，并使用推荐分级、评估、发展和评估系统对每项研究进行批判性评估。
数据库搜索产生了 315 篇独特的文章，其中 30 篇研究符合纳入和排除标准。其中，有 13 篇报告了可显示出统计学显著结果的数据，且未报告任何重大不良事件。由于存在严重的方法学缺陷和偏差，大多数研究被评为提供了较弱的临床证据。
该综述仅限于基于美国的研究和报告。审稿人之间的微小差异通过客观的第三方审稿人得到解决。
几乎没有强有力的、基于科学的、有证据支持的文献表明 OMM 对儿科护理具有治疗益处。由于其低风险特征，可以在医学上耐受，但不能做出强烈的临床推荐。需要进行高质量、科学严谨的 OMM 研究，以评估其在儿科的安全性、可行性和疗效。
