Faculty Collaboration Database

Assessing the quality of evidence for preterm labor tocolytic trials. J Matern Fetal Neonatal Med 2012 Sep;25(9):1646-52

Date

01/10/2012

Pubmed ID

22220680

DOI

10.3109/14767058.2011.650249

Scopus ID

2-s2.0-84865480879 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

OBJECTIVE: To assess the quality of tocolysis randomized controlled trials (RCTs) and to determine trial factors contributing to better quality evidence.

METHODS: The Cochrane Central Register of Controlled Trials, MEDLINE, MEDLINE In-Process, EMBASE and CINAHL were searched for terms "preterm labor," "tocolytic" or "obstetric labor, premature" up to 1 August 2009.Data regarding study design, characteristics, number of participants and outcomes reported were extracted by at least two review authors. Study quality was assigned using the Cochrane Collaboration Handbook methodology and categories. Trends for quality over time, the impact of study size and the individual drugs compared were analyzed for impact on overall quality of trials.

RESULTS: Of the 3197 titles initially identified, 89 RCTs of tocolytic therapy were reviewed. Of the six quality areas, 10 (11.2%) trials satisfied all areas, while only one trial (1.1%) met one area. The mean number of adequate areas was 4.1 ± 1.2. Overall, 52 (58.4%) of the trials achieved high-quality categorization. Controlling for multiple trial factors, the trial continent and decade were significant predictors of overall trial quality.

CONCLUSION: The majority of tocolysis RCTs are of high quality. Larger trials, more recent trials and placebo-controlled trials were associated with higher quality scores.

Author List

Haas DM, Kirkpatrick P, McIntosh JJ, Caldwell DM

Author

Jennifer Jury Mcintosh DO Associate Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Algorithms
Female
Humans
Obstetric Labor, Premature
Pregnancy
Quality Assurance, Health Care
Randomized Controlled Trials as Topic
Research Design
Tocolysis
Tocolytic Agents