Introduction: Systematic reviews (SRs) specific to children are essential to inform evidence-based practice. Child-relevant SRs in the Cochrane Database of Systematic Reviews (CDSR) have been characterized (2009, 2013), showing: limited child-specific evidence; variable methodological and reporting quality; some out-of- date evidence; and few SRs from developing countries. It is unknown whether SRs published outside of the CDSR may be complementary and/or suffer similar shortfalls. We aimed to characterize all non-Cochrane child-relevant SRs published in 2014. Methods: We searched four electronic databases for child-relevant SRs. A single reviewer screened articles for inclusion using a two-stage process (title/abstract, then full text); a second verified excluded studies only. Three reviewers independently extracted 3 broad categories of data: general characteristics; included study characteristics; methodological approaches. We checked all data for variables with <85% inter-reviewer agreement. We calculated descriptive statistics and presented the findings narratively. Results: We identified 1,598 child-relevant SRs (>4 published/day) containing a median (IQR) 19 (11, 33) studies. The SRs originated primarily from high income countries (n = 1,247, 78.0%) in North America (n = 534, 33.4%) or Europe (n = 535, 33.5%), and provided coverage over 47 of 53 Cochrane Review Groups (CRGs). Fifty-three percent of SRs fell into the top eight CRGs: Developmental, Psychosocial and Learning Problems (13.5%); Metabolic and Endocrine Disorders (8.3%); Pregnancy and Childbirth (7.8%); Common Mental Disorders (6.9%); Airways (4.4%); Anaesthesia, Critical and Emergency Care (4.3%); Public Health (4.2%); Infectious Diseases (3.8%). Most SRs synthesized therapeutic (n = 753, 47.1%) or epidemiologic (n = 701, 43.9%) evidence. Though half of the SRs included evidence either for children only (n = 628, 39.3%) or pregnancy (n = 176, 11.0%), few were published in pediatric journals (n = 273, 17.7%). Reporting quality varied; few SRs mentioned an a-priori protocol (n = 246, 15.4%) or registration (n = 111, 6.9%), and 23.4% specified a primary outcome. There were few updates (n = 32, 2.0%); more commonly, new SRs disregarded the availability of previous evidence syntheses on the same topic. Many 2 SRs relied solely on evidence from non-RCTs (n = 796, 49.8%). Less than two-thirds of SRs (n = 953, 59.6%) appraised the quality of included studies and assessments of the certainty of the body of evidence were rare (n = 102, 6.4%). The synthesis method used in SRs was roughly equally split between narrative (46.4%) and statistical (53.6%). Conclusion: There exists a wealth of child-relevant evidence from non-Cochrane SRs that may complement evidence contained in the CDSR. Many non-Cochrane SRs suffer methodological and reporting shortfalls, despite the availability of guidance for reviewers.
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