Pulmonary Hypertension among Children and Adolescents with Sickle Cell Anemia: A Systematic Review and Meta-analysis
Bibliographic record
Abstract
Pulmonary hypertension (PHT) is a major life-threatening complication associated with sickle cell anemia (SCA). However, there is scarcity of evidence in pooling the knowledge regarding the prevalence of PHT in the pediatric SCA patients. Hence, this systematic review was done to determine the pooled prevalence of PHT among SCA children and adolescents. Until January 2021, systematic searches were conducted in MEDLINE, SCOPUS, Web of Science, ScienceDirect, Cochrane library, and Google Scholar. The listed studies’ caliber was evaluated using the Newcastle Ottawa scale. The results of a meta-analysis using a random-effects model included a pooled prevalence and 95% confidence intervals (CIs). In total, 31 studies with 3686 participants were included in the study. Majority of the included studies (26 out of 31 studies) had low risk of bias. The final pooled prevalence of PHT among children and adolescents with SCA was 22% (95% CI: 18 – 26%). Maximum burden of PHT among SCA children was reported in Europe (26%) and Eastern Mediterranean region, while the least burden was found in Africa (17%). There was a significant heterogeneity found between the studies in our analysis (I2 = 87.8%; P < 0.001). The presence of publication bias indicated by an asymmetrical funnel plot was also found. About one in five children and adolescents with SCA suffer from PHTN. The burden is maximum in Europe followed by Eastern Mediterranean region. Diagnostic and intervention packages targeting these patients should be developed and implemented across the high-risk settings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.024 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.036 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".