Interventions to Treat Pediatric Iron Deficiency Anemia: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Objectives To perform comparative effectiveness and safety of interventions used to treat pediatric iron deficiency anemia (IDA), and to examine risk of bias and study sources of heterogeneity across the studies. Study design We searched major medical databases from inception to June 26, 2023. Eligibility criteria were children 6 months to 18 years with IDA receiving one of three interventions (oral iron, intravenous [IV] iron, red blood cell [RBC] transfusion). Hemoglobin change-from-baseline and incidence of adverse events were our primary outcomes. Data were synthesized quantitatively and narratively. When possible, random-effects meta-analysis was used to pool estimates. We used an indirect method to compare pooled estimates. Heterogeneity was examined using forest plots and the I 2 statistic. Results Of 2811 non-duplicate articles retrieved, 47 observational studies (4010 patients) were included. The pooled mean hemoglobin change-from-baseline favored IV iron compared with oral iron (26.66 g/L vs 22.08 g/L, difference=4.58 g/L, 95% CI: -2.77, 11.93). There were limited data on RBC transfusion. The pooled incidence of adverse events was 7.30% (IV iron), 8.41% (oral iron), 12.02% (RBC transfusion). Risk of bias was low or moderate for most studies. Sources of heterogeneity identified included severity of IDA, age, adherence to WHO definition of IDA and follow-up time. Conclusions Both oral and IV iron are effective in treating IDA. Our findings suggest that IV iron may be more effective in increasing hemoglobin, within a shorter period of time, with a favorable safety profile and could be considered more often in pediatric practice. Further research comparing these two treatments directly is warranted.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Review About the Canadian research system: no · About a Canadian topic: no | Meta-analysis | low |
| gpt | no category Domain: not available · Genre: Review About the Canadian research system: no · About a Canadian topic: no | Systematic review | high |
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 | 0.005 | 0.014 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.017 | 0.023 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.006 | 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, unvalidatedLabeled directly by 2 models reading the full record.
The models disagree on parts of this classification; every voice is preserved in the section at the end of the page.
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".