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Scope and quality of Cochrane reviews of nutrition interventions: a cross-sectional study

View Article: PubMed Central - PubMed

ABSTRACT

Background: All countries face significant challenges from complex manifestations of malnutrition, which affects one in three people globally. Systematic reviews provide ready-to-use syntheses of quality-appraised evidence to inform decision-making for actions. To enhance the utility and quality of future Cochrane nutrition evidence, we described the scope and quality of all nutrition systematic reviews in the Cochrane Database of Systematic Reviews (CDSR).

Methods: We screened all active CDSR records (31 July 2015) to identify reviews and protocols using pre-specified eligibility criteria and definitions. Duplicate, independent data extraction included criteria for inclusion of studies in completed reviews (PICOS). We assessed methodological quality (AMSTAR), use of GRADE, mapped reviews against 2013 Global Burden of Disease data, and categorised the paradigm (medical, lifestyle and socio-ecological) of the review question. We analysed our results using descriptive statistics.

Results: We screened 8484 records, and included 470 (8%) completed reviews (in 45 Cochrane Review Groups (CRGs)) and 169 (7%) protocols (in 41 CRGs) published by 47 of 53 CRGs with reviews. Most completed reviews were produced by the Pregnancy and Childbirth (n = 73), Neonatal (n = 64), Metabolic and Endocrine Disorders (n = 33), Developmental, Psychosocial and Learning Problems (n = 26), Kidney and Transplant (n = 18) and Heart (n = 18) CRGs. Only 27% (n = 129) of reviews had searches for new studies in 2013 or thereafter. Supplementation/supplement interventions were most common (50%; n = 235; majority with micronutrients; 73%, n = 173), followed by food interventions (20%; n = 95). All reviews included randomised controlled trials; about 5% included other designs; 25% used GRADE; the median AMSTAR score was 9 (interquartile range: 7 to 10), 51% were high (AMSTAR 9-11) and 49% moderate (AMSTAR 5-8) quality. More than 80% framed questions using a medical paradigm. For top causes of years-of-life-lost, most reviews addressed preterm birth, diabetes and ischaemic heart disease; for leading risk factors for disability-adjusted-life-years, most targeted childhood undernutrition and high body mass index.

Conclusions: Nutrition reviews comprised 8% of active CDSR records, were widely distributed across nearly all CRGs and reflected the double nutrition burden. This analysis presents a comprehensive description of the scope and quality of Cochrane nutrition reviews, and identifies gaps for future activities to support actions to address the nutrition burden, in line with the current nutrition agenda and impetus.

No MeSH data available.


a The percentage of completed nutrition reviews (n = 470) that examined the various categories of nutrition interventions b) The numbers of completed nutrition reviews that included the various categories of outcomes
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Fig4: a The percentage of completed nutrition reviews (n = 470) that examined the various categories of nutrition interventions b) The numbers of completed nutrition reviews that included the various categories of outcomes

Mentions: Nutrition was the primary intervention in most included reviews (86%; n = 406), and was delivered in combination with or as part of other interventions in the remaining reviews (14%; n = 64). Reviews of nutritional supplementation/supplements were the most common (50%; n = 235), followed by food interventions (20%; n = 95), combined food and supplementation interventions (9%; n = 43) and nutrition education (4%; n = 19) (Fig.Β 4a). Policy/program/system interventions comprised 3% of reviews (n = 14). Combinations of food and policy/program/system interventions, food and education, and education and policy/program/system interventions each made up about 3% of reviews. The small proportion of reviews (5%) included different combinations of the specified intervention categories (Fig.Β 4a). TableΒ 4 provides examples of reviews by type of intervention category.Fig. 4


Scope and quality of Cochrane reviews of nutrition interventions: a cross-sectional study
a The percentage of completed nutrition reviews (n = 470) that examined the various categories of nutrition interventions b) The numbers of completed nutrition reviews that included the various categories of outcomes
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5384134&req=5

Fig4: a The percentage of completed nutrition reviews (n = 470) that examined the various categories of nutrition interventions b) The numbers of completed nutrition reviews that included the various categories of outcomes
Mentions: Nutrition was the primary intervention in most included reviews (86%; n = 406), and was delivered in combination with or as part of other interventions in the remaining reviews (14%; n = 64). Reviews of nutritional supplementation/supplements were the most common (50%; n = 235), followed by food interventions (20%; n = 95), combined food and supplementation interventions (9%; n = 43) and nutrition education (4%; n = 19) (Fig.Β 4a). Policy/program/system interventions comprised 3% of reviews (n = 14). Combinations of food and policy/program/system interventions, food and education, and education and policy/program/system interventions each made up about 3% of reviews. The small proportion of reviews (5%) included different combinations of the specified intervention categories (Fig.Β 4a). TableΒ 4 provides examples of reviews by type of intervention category.Fig. 4

View Article: PubMed Central - PubMed

ABSTRACT

Background: All countries face significant challenges from complex manifestations of malnutrition, which affects one in three people globally. Systematic reviews provide ready-to-use syntheses of quality-appraised evidence to inform decision-making for actions. To enhance the utility and quality of future Cochrane nutrition evidence, we described the scope and quality of all nutrition systematic reviews in the Cochrane Database of Systematic Reviews (CDSR).

Methods: We screened all active CDSR records (31 July 2015) to identify reviews and protocols using pre-specified eligibility criteria and definitions. Duplicate, independent data extraction included criteria for inclusion of studies in completed reviews (PICOS). We assessed methodological quality (AMSTAR), use of GRADE, mapped reviews against 2013 Global Burden of Disease data, and categorised the paradigm (medical, lifestyle and socio-ecological) of the review question. We analysed our results using descriptive statistics.

Results: We screened 8484 records, and included 470 (8%) completed reviews (in 45 Cochrane Review Groups (CRGs)) and 169 (7%) protocols (in 41 CRGs) published by 47 of 53 CRGs with reviews. Most completed reviews were produced by the Pregnancy and Childbirth (n = 73), Neonatal (n = 64), Metabolic and Endocrine Disorders (n = 33), Developmental, Psychosocial and Learning Problems (n = 26), Kidney and Transplant (n = 18) and Heart (n = 18) CRGs. Only 27% (n = 129) of reviews had searches for new studies in 2013 or thereafter. Supplementation/supplement interventions were most common (50%; n = 235; majority with micronutrients; 73%, n = 173), followed by food interventions (20%; n = 95). All reviews included randomised controlled trials; about 5% included other designs; 25% used GRADE; the median AMSTAR score was 9 (interquartile range: 7 to 10), 51% were high (AMSTAR 9-11) and 49% moderate (AMSTAR 5-8) quality. More than 80% framed questions using a medical paradigm. For top causes of years-of-life-lost, most reviews addressed preterm birth, diabetes and ischaemic heart disease; for leading risk factors for disability-adjusted-life-years, most targeted childhood undernutrition and high body mass index.

Conclusions: Nutrition reviews comprised 8% of active CDSR records, were widely distributed across nearly all CRGs and reflected the double nutrition burden. This analysis presents a comprehensive description of the scope and quality of Cochrane nutrition reviews, and identifies gaps for future activities to support actions to address the nutrition burden, in line with the current nutrition agenda and impetus.

No MeSH data available.