Evidence map›Paper›PMID 37989356›Full record

SynthesisBMJ paediatrics open2023

Effectiveness of various treatment modalities in children with vesicoureteral reflux grades II-IV: a systematic review and network meta-analysis.

Chia-Lun Chang, Stephen Shei-Dei Yang, Chun-Kai Hsu, Chun-Hua Chen, Shang-Jen Chang

Open access · diamondAbstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in BMJ paediatrics open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
3.5field-weighted citation impact, top 7% 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

5 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Ultrasound andMedical journal of the Islamic Republic of Iran · 2025
    Article
  4. Review
  5. 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

5 authors at 2 institutions in 1 country.

Chia-Lun ChangDepartment of Urology, Taipei Tzu Chi General Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
Stephen Shei-Dei YangDepartment of Urology, Taipei Tzu Chi General Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
Chun-Kai HsuDepartment of Urology, Taipei Tzu Chi General Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
Chun-Hua ChenDepartment of Neurology, Taipei Municipal Wanfang hospital, Taipei, Taiwan.
Shang-Jen ChangDepartment of Urology, Taipei Tzu Chi General Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan 018484@ntuh.gov.tw.ORCID 0000-0003-1409-3853
Taipei Tzu Chi Hospital · TWTaipei Municipal YangMing Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVesicoureteral reflux (VUR) is one of the most common risk factors of urinary tract infection (UTI) among children. Various treatment modalities including antibiotic prophylaxis, surgical or endoscopic corrections and conservative treatment were used depending on the severity of VUR. The aim of this study is to compare the effectiveness of these treatment modalities in children with VUR grades II-IV by conducting a systematic review and network meta-analysis.

methodsA systematic search from different databases was performed from their earliest records to December 2022 without any language restriction. Only randomised controlled trials were included in this study. Effectiveness of treatment modalities was mainly compared by UTI. Other outcomes for renal scarring and resolution by renal units were also measured between treatments.

resultsA total of 11 studies with 1447 children were included in this study. While comparing with antibiotic prophylaxis in network meta-analysis for UTI recurrence, surgical treatment probably lowers the rate of UTI recurrence (Log OR -0.26, 95% CI -0.54 to 0.02, high quality). However, endoscopic treatment (Log OR 0.2, 95% CI -1.41 to 1.81, high quality) and conservative treatment (Log OR 0.15, 95% CI -0.45 to 0.75, high quality) revealed probably inferior to antibiotic treatment.

conclusionBoth pairwise and network meta-analytic results probably showed no difference between the treatments in terms of their impact on UTI recurrence, progression of previous renal scars, or formation of new renal scars in children with VUR grades II-IV. These findings may offer a better understanding of each treatment and evidence-based suggestions for the choice of treatment, which should be individualised and based on the patient's risk factors.

Indexed as

Urinary Tract InfectionsVesico-Ureteral RefluxChildCicatrixHumansKidneyRandomized Controlled Trials as TopicNephrologyStatistics

Identifiers

PMID37989356
PMCPMC10660918
OpenAlexW4388890558

What OpenQuestion holds

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LicenceCC BY-NC
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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.