Page 27 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

Data extraction
Using predefined criteria, titles and abstracts of all retrieved records and subsequently full- text articles were examined for eligibility independently by two authors. A cross-reference check of included articles was performed to identify articles possibly missed by our search strategy. The following data was extracted separately by the same two authors for all studies meeting the inclusion criteria: study population characteristics, study design, surgical method, duration of follow-up, number of participating subjects and events for each of the study outcomes of interest. In the case of discrepancies, a third author was consulted to obtain consensus. Methodological quality and risk of bias were assessed for every included study according to the PRISMA-statement 19, 20 and the Cochrane Collaboration’s tool for risk of bias assessment. 21
statistical analysis
If more than two studies reported on one of the outcomes of interest, studies were pooled in a meta-analysis. Results were presented as risk ratios (RRs) or weighted mean differences with 95% confidence intervals (CI). The alpha risk was set at 0.05. Data were pooled using the Mantel-Haenszel random-effects meta-analysis model. 22 The random-effects model was chosen to take into account suspected heterogeneity caused by differences in study design and patient population, as it generates a more conservative estimate than analysis using the fixed-effects model. 23 Studies were weighted on sample size and the number of events. Trials with zero events in one arm were included in the analysis by adding a continuity correction of 0.5 to all cells in the two-by-two table for that study. Trials with zero events in both arms were excluded from the meta-analysis. Heterogeneity was calculated using Higgins Chi-square test (p > 0.1). 24 Inconsistency in study effects was quantified by I2 values (I2 > 50%). 24,25 Funnel plots were used to help identify the presence of publication bias or other types of bias.26 All analyses were performed using the Review Manager software provided by The Cochrane Collaboration (version 5.1.7.).
ResULTs
After an extensive literature search, 2347 articles were initially identified. A total of five studies met our in- and exclusion criteria (Figure 1). 16,17,27-29 All studies had a retrospective study design. The five studies reported on a total of 550 PEG and 483 LGP procedures. Gastrostomy placements were performed between 1992 and 2008. Two out of the five studies reported on follow-up time (range 0–135.6 months). All study demographics and surgical techniques are summarized in Table 1. A risk of bias overview is given in Table 2.
Chapter 2
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