Caution is needed when assessing results of home birth–Authors’ reply
Notice bibliographique
Résumé
Meta-analyses are employed when clinical equipoise exists without definitive studies to provide certainty. Such analyses include all events from each study; data are treated as a whole data set. No disadvantage results from including small studies; indeed exclusion may bias outcomes. Where larger studies exist, the inclusion of smaller studies may not contribute significantly to point estimates, but are likely to decrease variance [[1]Turner R.M. Bird S.M. Higgins J.P.T The impact of study size on meta-analyses: examination of underpowered studies in Cochrane reviews.PLoSOne. 2013; 8 (Available from) ([accessed Sep 13 2019]): e59202https://www.researchgate.net/publication/236095347_The_Impact_of_Study_Size_on_Meta-analyses_Examination_of_Underpowered_Studies_in_Cochrane_ReviewsCrossref PubMed Scopus (355) Google Scholar]. Only 17% of 3905 meta-analyses in Cochrane Reviews in the specialty of gynecology had at least two adequately powered studies [[1]Turner R.M. Bird S.M. Higgins J.P.T The impact of study size on meta-analyses: examination of underpowered studies in Cochrane reviews.PLoSOne. 2013; 8 (Available from) ([accessed Sep 13 2019]): e59202https://www.researchgate.net/publication/236095347_The_Impact_of_Study_Size_on_Meta-analyses_Examination_of_Underpowered_Studies_in_Cochrane_ReviewsCrossref PubMed Scopus (355) Google Scholar]. Our study includes several large studies for most outcomes [[2]Hutton E.K. Reitsma A. Simioni J. et al.Perinatal or neonatal mortality among women who intend at the onset of labour to give birth at home compared to women of low obstetrical risk who intend to give birth in hospital: a systematic review and meta-analyses.Lancet E Clin Med. 2019; 14: 59-70https://doi.org/10.1016/j.eclinm.2019.07.005Summary Full Text Full Text PDF Scopus (36) Google Scholar]. When large adequately powered studies exist a rapid meta-analysis to estimate outcomes is possible [[1]Turner R.M. Bird S.M. Higgins J.P.T The impact of study size on meta-analyses: examination of underpowered studies in Cochrane reviews.PLoSOne. 2013; 8 (Available from) ([accessed Sep 13 2019]): e59202https://www.researchgate.net/publication/236095347_The_Impact_of_Study_Size_on_Meta-analyses_Examination_of_Underpowered_Studies_in_Cochrane_ReviewsCrossref PubMed Scopus (355) Google Scholar]. Thus, because the three studies that report late neonatal mortality as an outcome are among the large and better-powered studies together they provide a reasonable estimate [[1]Turner R.M. Bird S.M. Higgins J.P.T The impact of study size on meta-analyses: examination of underpowered studies in Cochrane reviews.PLoSOne. 2013; 8 (Available from) ([accessed Sep 13 2019]): e59202https://www.researchgate.net/publication/236095347_The_Impact_of_Study_Size_on_Meta-analyses_Examination_of_Underpowered_Studies_in_Cochrane_ReviewsCrossref PubMed Scopus (355) Google Scholar]. While no studies report outcomes after 28 days it is reassuring that few infants were admitted to NICU and admissions were less likely to occur among women planning home birth. This exceptionally rare outcome is unlikely to change overall findings of our study. We hope this clarifies why all relevant studies are included. In contrast to the contention that we provide a fragmented picture of infant outcomes we believe our paper assists in summarising literature. The question of how much evidence is enough remains. We support continued research on place of birth noting that despite benefits of hospital birth for low risk births never being demonstrated, the burden of proof lies on the doorstep of homes. No conflicts of interests applies. Perinatal or neonatal mortality among women who intend at the onset of labour to give birth at home compared to women of low obstetrical risk who intend to give birth in hospital: A systematic review and meta-analysesThe risk of perinatal or neonatal mortality was not different when birth was intended at home or in hospital. Full-Text PDF Open AccessCaution is needed when assessing results of home birthWe commend Hutton et al. [1] for their attempt to improve our understanding of the never ending medical and ethical dilemma of home birth. Full-Text PDF Open Access
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».