Are normative sonographic values of kidney size in children valid and reliable? A systematic review of the methodological quality of ultrasound studies using the Anatomical Quality Assessment (AQUA) tool.

BACKGROUND AND OBJECTIVES: A plethora of research is available on ultrasonographic kidney size standards. We performed a systematic review of methodological quality of ultrasound studies aimed at developing normative renal parameters in healthy children, by evaluating the risk of bias (ROB) using the 'Anatomical Quality Assessment (AQUA)' tool. METHODS: We searched Medline, Scopus, CINAHL, and Google Scholar on June 04 2018, and observational studies measuring kidney size by ultrasonography in healthy children (0-18 years) were included. The ROB of each study was evaluated in five domains using a 20 item coding scheme based on AQUA tool framework. RESULTS: Fifty-four studies were included. Domain 1 (subject characteristics) had a high ROB in 63% of studies due to the unclear description of age, sex, and ethnicity. The performance in Domain 2 (study design) was the best with 85% of studies having a prospective design. Methodological characterization (Domain 3) was poor across the studies (< 10% compliance), with suboptimal performance in the description of patient positioning, operator experience, and assessment of intra/inter-observer reliability. About three-fourth of the studies had a low ROB in Domain 4 (descriptive anatomy). Domain 5 (reporting of results) had a high ROB in approximately half of the studies, the majority reporting results in the form of central tendency measures. CONCLUSIONS: Significant deficiencies and heterogeneity were observed in the methodological quality of USG studies performed to-date for measurement of kidney size in children. We hereby provide a framework for the conducting such studies in future. PROSPERO (CRD42017071601).

Reporting quality of trial abstracts-improved yet suboptimal: A systematic review and meta-analysis.

OBJECTIVES: We conducted a systematic review and meta-analysis of literature to determine if the publication of the Consolidated Standards of Reporting Trials (CONSORT) abstract guideline in 2008 was followed by change in reporting quality of randomized controlled trial (RCT) abstracts. STUDY DESIGN AND SETTINGS: Evaluations were included if they compared reporting quality of RCT abstracts before and after the publication of CONSORT-abstract guideline. The literature search was performed (January 2008 to April 2017) in Medline (Ovid), EMbase, CINAHL plus and Cochrane methodologies register. We assessed study validity with a special validity tool, adapted from a previous Cochrane review. RESULTS: Initial search identified 4142 articles, of which total 10 evaluations including 5184 abstracts were included. Total 22 outcomes related to individual items of CONSORT-abstract guideline were assessed, and 14 showed significant effect sizes favoring CONSORT-abstract guideline. Despite significant effect size, the overall post-CONSORT reporting (PCR) was suboptimal for ten items: title (RR = 1.40, 95% CI 1.23 to 1.59, PCR = 53.4%), participants (RR = 1.58, 95% CI 1.11 to 2.26, PCR = 24.5%), primary outcome (RR = 1.12, 95% CI 1.02 to 1.23, PCR = 65%), blinding (RR = 2.13, 95% CI 1.20 to 3.76, PCR = 13.9%), trial status (RR = 1.81, 95% 1.39 to 2.35, PCR = 10.6%), numbers analyzed (RR = 1.51, 95% CI 1.15 to 1.98, PCR = 26.5%), outcome (RR = 1.40, 95% 1.05 to 1.86, PCR = 21.9%), effect size and precision (RR = 1.59, 95% CI 1.15 to 2.19, PCR = 58.9%), harms (RR = 1.24, 95% CI 1.04 to 1.48, PCR = 41.8%), trial registration (RR = 2.02, 95% CI 1.63 to 2.50, PCR = 33.8%). Three items with favorable effect size in addition had wide CIs: randomization (RR = -4.28, 95% CI 1.56 to 11.75, PCR = -3.3%), allocation concealment (RR = -19.89, 95% CI 1.54 to 256.69, PCR = -5.7%), and funding (RR = -22.61, 95% CI 8.13 to 62.67, PCR = -11.32%). CONCLUSION: The change in reporting quality of RCT abstracts is far from satisfactory, as evidenced by suboptimal post-CONSORT rates and wide CIs of effect sizes for majority of improved items. Mere publication of CONSORT-abstract guideline, without strict endorsement has failed to translate into good quality abstracts.

An interrupted time series analysis showed suboptimal improvement in reporting quality of trial abstract.

OBJECTIVE: To assess and compare the immediate and long-term change in reporting quality of randomized controlled trial (RCT) abstracts published in Pediatrics, The Journal of Pediatrics, and JAMA Pediatrics before and after the publication of Consolidated Standards of Reporting Trial (CONSORT)-abstract statement. STUDY DESIGN AND SETTINGS: Study had "Interrupted time-series" design. Eligible RCT abstracts were retrieved by PubMed search in two study periods from January 2003 to December 2007 (pre-CONSORT) and January 2010 to December 2014 (post-CONSORT). These abstracts were matched with the CONSORT checklist for abstracts. The primary outcome measure was CONSORT-abstract score defined as number of CONSORT items correctly reported divided by 18 and expressed as percentage. The mean percentage scores were used to compare reporting quality between pre- and post-CONSORT using segmented linear regression. RESULTS: A total of 424 RCT abstracts in pre-CONSORT and 467 in post-CONSORT were analyzed. A significant change in slope of regression line between two time periods (0.151 [confidence interval CI, 0.004-0.298], P = 0.044) was observed. Intercepts did not show a significant difference (-2.39 [CI, 4.93-0.157], P = 0.065). CONCLUSION: The overall reporting quality of RCT abstracts in the high-impact pediatrics journals was suboptimal (<50%); however, it improved when assessed over a 5-year period, implying slow but gradual adoption of guideline.

Reporting standards for Bland-Altman agreement analysis in laboratory research: a cross-sectional survey of current practice.

BACKGROUND AND OBJECTIVES: To carry out a cross-sectional survey of the medical literature on laboratory research papers published later than 2012 and available in the common search engines (PubMed, Google Scholar) on the quality of statistical reporting of method comparison studies using Bland-Altman (B-A) analysis. METHODS: Fifty clinical studies were identified which had undertaken method comparison of laboratory analytes using B-A. The reporting of B-A was evaluated using a predesigned checklist with following six items: (1) correct representation of x-axis on B-A plot, (2) representation and correct definition of limits of agreement (LOA), (3) reporting of confidence interval (CI) of LOA, (4) comparison of LOA with a priori defined clinical criteria, (5) evaluation of the pattern of the relationship between difference (y-axis) and average (x-axis) and (6) measures of repeatability. RESULTS AND INTERPRETATION: The x-axis and LOA were presented correctly in 94%, comparison with a priori clinical criteria in 74%, CI reporting in 6%, evaluation of pattern in 28% and repeatability assessment in 38% of studies. CONCLUSIONS: There is incomplete reporting of B-A in published clinical studies. Despite its simplicity, B-A appears not to be completely understood by researchers, reviewers and editors of journals. There appear to be differences in the reporting of B-A between laboratory medicine journals and other clinical journals. A uniform reporting of B-A method will enhance the generalizability of results.

Impact of an educational intervention on hand hygiene compliance and infection rate in a developing country neonatal intensive care unit.

Nosocomial infections are a significant problem in neonatal intensive care units (NICUs) and hand hygiene (HH) has been stated as an effective mean to prevent spread of infections. The aim of study was to assess the baseline compliance HH practices and to evaluate the impact of hand washing educational programme on infection rate in a NICU. Continuous surveillance of nosocomial infections was done. A total of 15,797 and 12 ,29 opportunities for HH were observed in pre-intervention and postintervention phases, respectively. Compliance of health-care workers for all HH opportunities combined was 46% before intervention and improved significantly to 69% in postintervention (RR 1.49, CI 1.46-1.52, P < 0.0001). Compliance for nurses and doctors was similar. Nosocomial sepsis rate showed a significant decline from 96 per 1000 patient-days in pre-intervention to 47 per 1000 patient-days in postintervention phase (RR 0.44, CI 0.33-0.58, P < 0.0001). We conclude that effective HH practices can serve as an economical and effective nosocomial infection control approach especially important in developing nations.