Viswas Chhapola1, Soumya Tiwari2, Bobbity Deepthi2, Brandon Michael Henry3,4, Rekha Brar5, Sandeep Kumar Kanwal2. 1. Department of Pediatrics, Kalawati Saran Children's Hospital and Lady Hardinge Medical College, Bangla Sahib Road, New Delhi, 110001, India. viswaschhapola@gmail.com. 2. Department of Pediatrics, Kalawati Saran Children's Hospital and Lady Hardinge Medical College, Bangla Sahib Road, New Delhi, 110001, India. 3. International Evidence-Based Anatomy Working Group, Kraków, Poland. 4. Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 5. Indira IVF Centre, Patel Nagar, New Delhi, India.
Abstract
BACKGROUND AND OBJECTIVES: A plethora of research is available on ultrasonographic kidney size standards. We performed a systematic review of methodological quality of ultrasound studies aimed at developing normative renal parameters in healthy children, by evaluating the risk of bias (ROB) using the 'Anatomical Quality Assessment (AQUA)' tool. METHODS: We searched Medline, Scopus, CINAHL, and Google Scholar on June 04 2018, and observational studies measuring kidney size by ultrasonography in healthy children (0-18 years) were included. The ROB of each study was evaluated in five domains using a 20 item coding scheme based on AQUA tool framework. RESULTS: Fifty-four studies were included. Domain 1 (subject characteristics) had a high ROB in 63% of studies due to the unclear description of age, sex, and ethnicity. The performance in Domain 2 (study design) was the best with 85% of studies having a prospective design. Methodological characterization (Domain 3) was poor across the studies (< 10% compliance), with suboptimal performance in the description of patient positioning, operator experience, and assessment of intra/inter-observer reliability. About three-fourth of the studies had a low ROB in Domain 4 (descriptive anatomy). Domain 5 (reporting of results) had a high ROB in approximately half of the studies, the majority reporting results in the form of central tendency measures. CONCLUSIONS: Significant deficiencies and heterogeneity were observed in the methodological quality of USG studies performed to-date for measurement of kidney size in children. We hereby provide a framework for the conducting such studies in future. PROSPERO (CRD42017071601).
BACKGROUND AND OBJECTIVES: A plethora of research is available on ultrasonographic kidney size standards. We performed a systematic review of methodological quality of ultrasound studies aimed at developing normative renal parameters in healthy children, by evaluating the risk of bias (ROB) using the 'Anatomical Quality Assessment (AQUA)' tool. METHODS: We searched Medline, Scopus, CINAHL, and Google Scholar on June 04 2018, and observational studies measuring kidney size by ultrasonography in healthy children (0-18 years) were included. The ROB of each study was evaluated in five domains using a 20 item coding scheme based on AQUA tool framework. RESULTS: Fifty-four studies were included. Domain 1 (subject characteristics) had a high ROB in 63% of studies due to the unclear description of age, sex, and ethnicity. The performance in Domain 2 (study design) was the best with 85% of studies having a prospective design. Methodological characterization (Domain 3) was poor across the studies (< 10% compliance), with suboptimal performance in the description of patient positioning, operator experience, and assessment of intra/inter-observer reliability. About three-fourth of the studies had a low ROB in Domain 4 (descriptive anatomy). Domain 5 (reporting of results) had a high ROB in approximately half of the studies, the majority reporting results in the form of central tendency measures. CONCLUSIONS: Significant deficiencies and heterogeneity were observed in the methodological quality of USG studies performed to-date for measurement of kidney size in children. We hereby provide a framework for the conducting such studies in future. PROSPERO (CRD42017071601).
Entities:
Keywords:
AQUA tool; Kidney length; Kidney size nomogram; Kidney volume; Kidney/anatomy and histology; Kidney/growth and development
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