Systematic Reviews and Meta-Analyses in Pediatric Neurosurgery: Essential Domains for a Pediatric Neurosurgeon

BACKGROUND: A rise in systematic reviews and meta-analyses (SRMAs) within the neurosurgical literature has been fueled by an increasing amount of published metadata. In the pediatric niche, multiple pediatric-specific consid-erations must be made by pediatric neurosurgeons to ensure that their inter-pretation of pediatric neurosurgical SRMAs is appropriate. The objective of this review is to highlight 4 essential domains in this setting that will allow readers to more appropriately interpret pediatric neurosurgical SRMAs. METHODS: The domains reviewed are 1) formulating an appropriate search strategy to incorporate all possible studies involving pediatric patients, 2) un-derstanding how the limited quality of pediatric neurosurgical metadata affects certainty of reported findings, 3) using suitable statistical modeling that adjusts for the intrinsic and interstudy differences between contributing pediatric studies, and 4) ensuring that clinical applications of SRMA findings are appropriate in the pediatric demographic.RESULTS: Each of the 4 domains can be tailored toward pediatric neurosur-gery when composing SRMAs. Examples provided demonstrate where writers should be specific and what readers should be aware of to ensure findings are interpreted correctly and effectively in this niche.CONCLUSIONS: In understandings these 4 essential domains, practicing pediatric neurosurgeons will be better equipped to critically evaluate SRMAs and ultimately inform their academic and evidence-based practices.