title: Clinical recommendations of Cochrane reviews in pediatric gastroenterology: systematic analysis.
abstract: BACKGROUND
  Systematic and up-to-date Cochrane reviews in pediatrics in general and in pediatric gastroenterology in particular are important tools in disseminating the best available evidence to the medical community, thus providing the physician at the bedside with invaluable information and recommendations with regard to specific clinical questions.
  
  
  METHODS
  A systematic literature review was conducted, including all Cochrane reviews published by the Cochrane Review Group in the field of pediatric gastroenterology between 1993 and 2012, with regard to the percentage of reviews that concluded that a certain intervention provided a benefit, percentage of reviews that concluded that a certain intervention should not be performed, and percentage of studies that concluded that the current level of evidence was inconclusive.
  
  
  RESULTS
  In total, 86 reviews in the field of pediatric gastroenterology were included. The majority of reviews assessed pharmacological interventions (46/86); other important fields included prevention (15/86) and nutrition (9/86). A total of 33/86 reviews issued definite recommendations (positive, 19/86; negative, 14/86). The remaining 53/86 reviews were either inconclusive (24/86) or only of limited conclusiveness (29/86). The percentage of inconclusive reviews increased from 9% (1998-2002) to 19% (2003-2007; P < 0.05) to finally 24% (2008-2012) (P < 0.05). The three most common reasons for the need for further research were heterogeneity of studies (26/86), small number of patients (18/86), and insufficient data (16/86).
  
  
  CONCLUSIONS
  Further high-quality research is necessary to increase the proportion of reviews with clear recommendations. Funding and research agencies are key to selecting the most appropriate research programs.
authors: Medical School, University of Saarland, Homburg, Germany.
authors: Yvonne
authors: Y
authors: Goda
authors: Harald
authors: H
authors: Sauer
authors: Dominik
authors: D
authors: Schöndorf
authors: Pia
authors: P
authors: Hennes
authors: Ludwig
authors: L
authors: Gortner
authors: Stefan
authors: S
authors: Gräber
authors: Sascha
authors: S
authors: Meyer
mesh_terms: D002648:Child; D002983:Clinical Competence; D005762:Gastroenterology / Q000592:standards*; D006801:Humans; D010820:Physicians / Q000592:standards*; D017410:Practice Guidelines as Topic
keywords: Cochrane review; children; evidence-based medicine; gastroenterology; meta-analysis; pediatrics