SynthesisEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2018
Randomized controlled trials in children's heart surgery in the 21st century: a systematic review.
Synthesis in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Cardioplegia in paediatric cardiac surgery: a systematic review of randomized controlled trials.Interactive cardiovascular and thoracic surgery · 2019Pooled it
- Understanding parents' decision-making on participation in clinical trials in children's heart surgery: a qualitative study.BMJ open · 2021Trial
- Neuromonitoring and neuroprotection during neonatal aortic arch surgery: A United Kingdom and Ireland survey.Perfusion · 2026Article
- Outcomes of Infant Cardiac Surgery Using Institutional vs Commercial Cardioplegia Solution: A Comparative Analysis.Annals of thoracic surgery short reports · 2025Article
- The art, science, and economics of congenital heart surgery in India.Indian journal of thoracic and cardiovascular surgery · 2025Article
- Article
- Myocardial protection in paediatric cardiac surgery: building an evidence-based strategy.Annals of the Royal College of Surgeons of England · 2024Article
- Implementing early rehabilitation and mobilisation for children in UK paediatric intensive care units: the PERMIT feasibility study.Health technology assessment (Winchester, England) · 2023Article
- Multicenter Clinical Research in Congenital Heart Disease: Leveraging Research Networks to Investigate Important Unanswered Questions.NeoReviews · 2023Review
- Article
- Research priorities in children and adults with congenital heart disease: a James Lind Alliance Priority Setting Partnership.Open heart · 2022Article
- Challenges to Randomized Trials in Adult and Congenital Cardiac and Thoracic Surgery.The Annals of thoracic surgery · 2022Review
- A Survey of Resources and Nursing Workforce for Clinical Research Delivery in Paediatric Intensive Care Within the UK / Ireland.Frontiers in pediatrics · 2022Article
- Standing on the shoulders of Giants: a citation analysis of the paediatric congenital heart disease literature.Cardiology in the young · 2021Article
- Medicine-Based Evidence in Congenital Heart Disease: How Artificial Intelligence Can Guide Treatment Decisions for Individual Patients.Frontiers in cardiovascular medicine · 2021Article
- Congenital heart surgery avidly awaits evidence.Indian journal of thoracic and cardiovascular surgery · 2021Article
- Article
- Critical components for designing and implementing randomized controlled trials.Pediatric investigation · 2018Article
- Pediatric cardiology: In search for evidence.Annals of pediatric cardiologyArticle
- The paucity of high-level evidence for therapy in pediatric cardiology.Annals of pediatric cardiologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesRandomized controlled trials are the gold standard for evaluating health care interventions, yet are uncommon in children's heart surgery. We conducted a systematic review of clinical trials in paediatric cardiac surgery to evaluate the scope and quality of the current international literature.
methodsWe searched MEDLINE, CENTRAL and LILACS, and manually screened retrieved references and systematic reviews to identify all randomized controlled trials reporting the effect of any intervention on the conduct or outcomes of heart surgery in children published in any language since January 2000; secondary publications and those reporting inseparable adult data were excluded. Two reviewers independently screened studies for eligibility and extracted data; the Cochrane Risk of Bias tool was used to assess for potential biases.
resultsWe identified 333 trials from 34 countries randomizing 23 902 children. Most were early phase (313, 94.0%), recruiting few patients (median 45, interquartile range 28-82), and only 11 (3.3%) directly evaluated a surgical intervention. One hundred and nine (32.7%) trials calculated a sample size, 52 (15.6%) reported a CONSORT diagram, 51 (15.3%) were publicly registered and 25 (7.5%) had a Data Monitoring Committee. The overall risk of bias was low in 22 (6.6%), high in 69 (20.7%) and unclear in 242 (72.7%).
conclusionsThe recent literature in children's heart surgery contains few late-phase clinical trials. Most trials did not conform to the accepted standards of reporting, and the overall risk of bias was low in few studies. There is a need for high-quality, multicentre clinical trials to provide a robust evidence base for contemporary paediatric cardiac surgical practice.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.