Gastrointestinal symptom improvement in infants after restrictive tethered oral tissue release: a systematic review and meta analysis
Bibliographic record
Abstract
Purpose: The purpose of this systematic review was to systematically explore improvements in gastrointestinal symptoms 1 week and 1 month following the frenotomy procedure, compared to before the procedure for infants under 12 months of age using meta-analysis calculations. Methods: Studies were selected that presented data on breastfed infants under 12 months of age, with gastrointestinal symptoms and reflux, who underwent surgical correction for restricted maxillary labial frenum and/or ankyloglossia, and/or maxillary buccal frena. Case reports, letters to editors, previous systematic reviews, in vitro and animal studies, and only abstracts were excluded. An integrative literature review was carried out in MEDLINE via PubMed, EBSCOhost, Scopus Embase, Web of Science & Cochrane Library from April 2016 to March 2023. Risk of bias was evaluated using the Modified Newcastle‐Ottawa Scale. GRADE profiler (GRADEpro) was used to rate the quality of evidence. We conducted meta-analysis using random effects modelling with the RevMan Software 5.4. Results: Out of the 90 studies identified, nine studies were included, seven were prospective cohort studies, one was a prospective randomized trial, and one was a retrospective analysis. Gastroesophageal reflux symptoms showed statistically significant improvement in I-GERQ-R scores after 1 week (effect size = 3.40, p < 0.00001) and 1 month (effect size = 6.37, p Conclusion: Tethered oral tissues should be considered as a potential etiology in the differential diagnosis of gastrointestinal reflux in infants.
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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 | 0.011 | 0.029 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.021 | 0.036 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| 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".