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A critical appraisal of the evidence for using cardiotocography plus ECG ST interval analysis for fetal surveillance in labor. Part II: the meta-analyses.

Olofsson, Per LU ; Ayres-de-Campos, Diogo; Kessler, Jörg; Tendal, Britta; Yli, Branka M and Devoe, Lawrence (2014) In Acta Obstetricia et Gynecologica Scandinavica 93(6). p.571-586
Abstract
We appraised the methodology, execution and quality of the five published meta-analyses that are based on the five randomized controlled trials (RCTs) which compared cardiotocography (CTG) +ST analysis to CTG. The meta-analyses contained errors, either created de novo in handling of original data, or from a failure to recognize essential differences among the RCTs, particularly in their inclusion criteria and outcome parameters. No meta-analysis contained complete and relevant data from all five RCTs. We believe that one RCT excluded in two of the meta-analyses should have been included, while one RCT that was included in all meta-analyses, should have been excluded. After correction of the uncovered errors and exclusion of the RCT that we... (More)
We appraised the methodology, execution and quality of the five published meta-analyses that are based on the five randomized controlled trials (RCTs) which compared cardiotocography (CTG) +ST analysis to CTG. The meta-analyses contained errors, either created de novo in handling of original data, or from a failure to recognize essential differences among the RCTs, particularly in their inclusion criteria and outcome parameters. No meta-analysis contained complete and relevant data from all five RCTs. We believe that one RCT excluded in two of the meta-analyses should have been included, while one RCT that was included in all meta-analyses, should have been excluded. After correction of the uncovered errors and exclusion of the RCT that we deemed inappropriate, our new meta-analysis showed that CTG+ST monitoring significantly reduces the fetal scalp blood sampling usage (risk ratio 0.64; 95% confidence interval 0.47-0.88), total operative delivery rate (0.93; 0.88-0.99), and metabolic acidosis rate (0.61; 0.41-0.91). This article is protected by copyright. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Obstetricia et Gynecologica Scandinavica
volume
93
issue
6
pages
571 - 586
publisher
Wiley-Blackwell
external identifiers
  • pmid:24797318
  • wos:000337566200010
  • scopus:84901641480
ISSN
1600-0412
DOI
10.1111/aogs.12412
language
English
LU publication?
yes
id
545f2dfb-acdb-4adc-aace-9805bfae02a1 (old id 4455849)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24797318?dopt=Abstract
date added to LUP
2014-06-03 19:28:18
date last changed
2017-07-02 03:10:10
@article{545f2dfb-acdb-4adc-aace-9805bfae02a1,
  abstract     = {We appraised the methodology, execution and quality of the five published meta-analyses that are based on the five randomized controlled trials (RCTs) which compared cardiotocography (CTG) +ST analysis to CTG. The meta-analyses contained errors, either created de novo in handling of original data, or from a failure to recognize essential differences among the RCTs, particularly in their inclusion criteria and outcome parameters. No meta-analysis contained complete and relevant data from all five RCTs. We believe that one RCT excluded in two of the meta-analyses should have been included, while one RCT that was included in all meta-analyses, should have been excluded. After correction of the uncovered errors and exclusion of the RCT that we deemed inappropriate, our new meta-analysis showed that CTG+ST monitoring significantly reduces the fetal scalp blood sampling usage (risk ratio 0.64; 95% confidence interval 0.47-0.88), total operative delivery rate (0.93; 0.88-0.99), and metabolic acidosis rate (0.61; 0.41-0.91). This article is protected by copyright. All rights reserved.},
  author       = {Olofsson, Per and Ayres-de-Campos, Diogo and Kessler, Jörg and Tendal, Britta and Yli, Branka M and Devoe, Lawrence},
  issn         = {1600-0412},
  language     = {eng},
  number       = {6},
  pages        = {571--586},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Obstetricia et Gynecologica Scandinavica},
  title        = {A critical appraisal of the evidence for using cardiotocography plus ECG ST interval analysis for fetal surveillance in labor. Part II: the meta-analyses.},
  url          = {http://dx.doi.org/10.1111/aogs.12412},
  volume       = {93},
  year         = {2014},
}