Document Detail


Inborn/outborn status and neonatal survival: a meta-analysis of non-randomized studies.
MedLine Citation:
PMID:  3231945     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We have applied meta-analysis to investigate the relationship between birth place and the likelihood of neonatal survival, for infants of low birth weight (less than 2501 grams) in a series of 19 non-randomized studies. This paper illustrates the utility meta-analysis in evaluating medical technologies described in non-randomized studies, if proper attention is given to biases in those studies. The results of this meta-analysis show strong preferences for inborn status, especially for infants who weigh 1001-2000 grams. For infants of lower or higher birth weight (that is, less than 1001 or greater than 2000 grams), the studies are inconsistent: some favour inborn status while others favour outborn status. This heterogeneity is not surprising, because selection bias is more problematic in studies of infants at these birth weights. We discuss potential causes of and solutions to selection bias and illustrate its potential magnitude by introducing the bias factor, which should be considered in the design of future studies. When selection bias cannot be ruled out, the results shown for those who weigh 1001-2000 grams are more appropriate for generating valid conclusions and subsequent policies regarding birth place preference for low birth weight infants.
Authors:
R J Ozminkowski; P M Wortman; D W Roloff
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Statistics in medicine     Volume:  7     ISSN:  0277-6715     ISO Abbreviation:  Stat Med     Publication Date:  1988 Dec 
Date Detail:
Created Date:  1989-04-20     Completed Date:  1989-04-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8215016     Medline TA:  Stat Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1207-21     Citation Subset:  IM    
Affiliation:
Program in Health Services Organization and Policy, School of Public Health, University of Michigan, Ann Arbor 48109-2029.
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MeSH Terms
Descriptor/Qualifier:
Birth Weight
Humans
Infant Mortality*
Infant, Low Birth Weight / statistics & numerical data*
Infant, Newborn
Intensive Care Units, Neonatal / statistics & numerical data*
Meta-Analysis as Topic*
Random Allocation
Grant Support
ID/Acronym/Agency:
HL 34275/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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