Conclusiveness of the cochrane reviews in pediatric-gastroenterology: A systematic analysis

AIM: To assess the conclusiveness of the Cochrane Reviews (CRs) in the field of Pediatric-Gastroenterology. We tested the hypotheses that (a) the majority of CRs are inconclusive, (b) the majority of CRs recognize the need for further studies, (c) the ability to reach a conclusion is dependent on both the number of studies and the number of patients. We also studied whether the conclusiveness of CRs changed over time. METHODS: We selected all CRs in the field of Pediatric-Gastroenterology available in the Cochrane library. Each CR was analyzed for the number of randomized clinical trials (RCTs) found, the number of RCTs included for analysis, the number of patients enrolled, the stated need for further studies, and the conclusiveness of the CR. RESULTS: Sixty-eight out of 85 CRs (80%) were conclusive. The percentage of articles included in conclusive studies was significantly higher than that in inconclusive ones (P<0.00001). Thus, the average number of RCTs retained in the analyses was significantly higher in conclusive CRs. The total number of patients in the RCTs retained for analysis was significantly higher in conclusive CRs (P<0.0001). The majority of inconclusive CRs (82.4%) recognized the need for further studies compared with 44.1% in conclusive ones (P=0.002). The percentage of conclusive CRs was not affected by the year of publication. CONCLUSION: In the field of Pediatric-Gastroenterology, CRs appear to be a potent clinical tool that allows, in 80% of the cases, to reach a valid (from a clinical standpoint) conclusion, while emphasizing the weaknesses of available, published evidence and delineating future avenues of research.