Evidence map›Paper›PMID 33250180›Full record

SynthesisBritish journal of anaesthesia2021

Prospectively assessed neurodevelopmental outcomes in studies of anaesthetic neurotoxicity in children: a systematic review and meta-analysis.

Caleb Ing, William M Jackson, Michael J Zaccariello, Terry E Goldberg, Mary-Ellen McCann, Anneke Grobler, Andrew Davidson, Lena Sun, Guohua Li, David O Warner

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of anaesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed, 6 pooled it
10.0field-weighted citation impact, top 1% of its field
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

62 citing papers in PubMed, 6 syntheses or guidelines pooled it, 130 citations in OpenAlex.

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2 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 2 countries.

Caleb IngDepartment of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, New York, NY, USA. Electronic address: ci2119@cumc.columbia.edu.
William M JacksonDepartment of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
Michael J ZaccarielloDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
Terry E GoldbergDepartment of Psychiatry and Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
Mary-Ellen McCannDepartment of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA.
Anneke GroblerDepartment of Paediatrics, University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia.
Andrew DavidsonMurdoch Children's Research Institute, Melbourne, Australia; Department of Anaesthesia and Pain Management, Royal Children's Hospital, Melbourne, Australia.
Lena SunDepartments of Anesthesiology and Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
Guohua LiDepartment of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, New York, NY, USA.
David O WarnerDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Columbia University · USBoston Children's Hospital · USMayo Clinic · USMayo Clinic in Arizona · USRoyal Children's Hospital · AUThe University of Melbourne · AU

Funding

Prenatal Exposure to Anesthesia and Subsequent Neurodevelopmental DisordersR01HS026493 · AHRQ · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI ING, CALEB · 2018 to 2022
$1.6M
AHRQ HHS R01 HS026493
6 · The paper itself

Abstract

backgroundWhether exposure to a single general anaesthetic (GA) in early childhood causes long-term neurodevelopmental problems remains unclear.

methodsPubMed/MEDLINE, Embase, CINAHL, Web of Science, and the Cochrane Library were searched from inception to October 2019. Studies evaluating neurodevelopmental outcomes and prospectively enrolling children exposed to a single GA procedure compared with unexposed children were identified. Outcomes common to at least three studies were evaluated using random-effects meta-analyses.

resultsFull-scale intelligence quotient (FSIQ); the parentally reported Child Behavior Checklist (CBCL) total, externalising, and internalising problems scores; and Behavior Rating Inventory of Executive Function (BRIEF) scores were assessed. Of 1644 children identified, 841 who had a single exposure to GA were evaluated. The CBCL problem scores were significantly higher (i.e. worse) in exposed children: mean score difference (CBCL total: 2.3 [95% confidence interval {CI}: 1.0-3.7], P=0.001; CBCL externalising: 1.9 [95% CI: 0.7-3.1], P=0.003; and CBCL internalising problems: 2.2 [95% CI: 0.9-3.5], P=0.001). Differences in BRIEF were not significant after multiple comparison adjustment. Full-scale intelligence quotient was not affected by GA exposure. Secondary analyses evaluating the risk of these scores exceeding predetermined clinical thresholds found that GA exposure was associated with increased risk of CBCL internalising behavioural deficit (risk ratio [RR]: 1.47; 95% CI: 1.08-2.02; P=0.016) and impaired BRIEF executive function (RR: 1.68; 95% CI: 1.23-2.30; P=0.001).

conclusionsCombining results of studies utilising prospectively collected outcomes showed that a single GA exposure was associated with statistically significant increases in parent reports of behavioural problems with no difference in general intelligence.

Indexed as

Child BehaviorChild DevelopmentAge FactorsAnesthetics, GeneralChild Behavior DisordersChild, PreschoolExecutive FunctionHumansIntelligenceNervous SystemNeurotoxicity SyndromesRisk AssessmentRisk FactorsAnesthetics, Generalanaesthetic neurotoxicitybehavioural deficitmeta-analysisneurodevelopmentpaediatric anaesthesiasystematic review

Identifiers

PMID33250180
PMCPMC8040118
OpenAlexW3110267241

What OpenQuestion holds

Textmetadata
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.