Evidence map›Paper›PMID 27708469›Full record

ReviewBulletin of the World Health Organization2016

Inpatient management of children with severe acute malnutrition: a review of WHO guidelines.

Kirkby D Tickell, Donna M Denno

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Bulletin of the World Health Organization, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Article
  7. Observational
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Observational
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Kirkby D TickellDepartment of Epidemiology, University of Washington, Seattle, United States of America (USA).
Donna M DennoDepartments of Pediatrics and Global Health, University of Washington, 6200 NE 74th Street, Suite 110, Box 354920, Seattle, WA 98115, USA .

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo understand how the World Health Organization's (WHO's) guidelines on the inpatient care of children with complicated severe acute malnutrition may be strengthened to improve outcomes.

methodsIn December 2015, we searched Google scholar and WHO's website for WHO recommendations on severe acute malnutrition management and evaluated the history and cited evidence behind these recommendations. We systematically searched WHO International Clinical Trials Registry Platform, clinicaltrials.gov and the Controlled Trials metaRegister until 10 August 2015 for recently completed, ongoing, or pending trials.

findingsWHO's guidelines provide 33 recommendations on the topic. However, 16 (48.5%) of these recommendations were based solely on expert opinion - unsupported by published evidence. Another 11 (33.3%) of the recommendations were supported by the results of directly relevant research - i.e. either randomized trials (8) or observational studies (3). The other six recommendations (18.2%) were based on studies that were not conducted among children with complicated severe malnutrition or studies of treatment that were not identical to the recommended intervention. Trials registries included 20 studies related to the topic, including nine trials of alternative feeding regimens. Acute medical management and follow-up care studies were minimally represented.

conclusionWHO's guidelines on the topic have a weak evidence base and have undergone limited substantive adjustments over the past decades. More trials are needed to make that evidence base more robust. If the mortality associated with severe malnutrition is to be reduced, inpatient and post-discharge management trials, supported by studies on the causes of mortality, are needed.

Indexed as

Practice Guidelines as TopicAnti-Retroviral AgentsChildChild, PreschoolClinical Trials as TopicDisease ManagementHIV InfectionsHumansInpatientsIsotonic SolutionsMicronutrientsRinger's SolutionSevere Acute MalnutritionWorld Health OrganizationAnti-Retroviral AgentsIsotonic SolutionsMicronutrientsRinger's Solution

Identifiers

PMID27708469
PMCPMC5034633

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.