An analysis of the appropriateness of the statistical methodology and data reporting used in paediatric weight estimation studies - A systematic review

Abstract

Background: Accurate paediatric weight estimation systems are critical for safe drug dosing in emergency care. However, the validity of many of the studies evaluating the accuracy of these systems has been questioned. The objective of this systematic review was to analyse the appropriateness of the study design, statistical methodology and data presentation in published paediatric weight estimation studies. Methods: Studies that evaluated paediatric weight estimation systems, published between January 1986 and January 2023, were identified. Data extraction included publication details, study types, weight estimation methods under investigation, statistical methods, and subgroup analyses. Study quality and risk of bias was evaluated using the Newcastle-Ottawa tool. Main results: The review included 193 articles spanning a 32-year period. Only about a third (64/193 (33.2%)) of the studies employed comprehensive and appropriate statistics and metrics for evaluating weight estimation methods, while 81/193 (41.5%) relied solely on inappropriate metrics and statistics. Subgroup analyses were not performed in 137/193 (71.0%), with appropriate subgroup analyses only reported in 13/193 (6.7%) of studies. Poor sampling methods, inadequate inclusion/exclusion criteria, insufficient statistical analysis, suboptimal data reporting, and inadequate use of subgroup analyses frequently compromised the study findings. Conclusions: This study identified major limitations in the design, methodology, and data analysis of a significant proportion of paediatric weight estimation studies. These limitations had a major impact on the validity of many of the studies. The need for specific guidelines on study design, statistical methodology, subgroup analyses, and data presentation in this field is evident.