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BACKGROUND: Pharmaceutical industry-sponsored research has been shown to be biased toward reporting positive results. Frequent industry participation in trials assessing the efficacy of inhaled corticosteroid (ICS) and long-acting beta2-agonist (LABA) combination treatment makes assessing industry influence difficult and warrants an assessment of specific potential publication bias in this area.

Introduction: Performing systematic review searches related to Canadian Indigenous peoples (First Nations, Inuit, and Métis), particularly in areas of public health, is difficult because Medical Subject Headings (MeSH) terms for both Indigenous peoples and geography do not retrieve all relevant articles in Ovid MEDLINE. Text–word searching for Canadian Indigenous peoples presents challenges in the varieties of names, spellings, and languages. A series of Canadian Indigenous peoples filters were designed to retrieve larger numbers of relevant articles. Objectives: The objectives of this work were (i) to create first-generation search filters that retrieve studies from the Ovid MEDLINE database related to Canadian Indigenous peoples, (ii) to determine whether or not the filters retrieve more records than do searches using the MeSH headings alone, and (iii) to determine how many of the additional records are relevant. Methods: Key terms describing both Canadian Indigenous peoples and Canadian geography were identified using government, historical, and ethnographic publications. Name lists included current and historical names in multiple languages, as well as local and settlement names, and names of linguistic groups. Filters, employing both text–word and MeSH terms were created for each province and territory, excluding Prince Edward Island. Search results were reviewed for false recalls related to terms with multiple meanings and groups of people whose lands straddle provincial and territorial borders. Revised searches were refined with additional terminology that implies the presence of Indigenous peoples. Duplicate records were removed from both the MeSH searches and the filter searches. Results from the MeSH searches were then removed from the results of the filter searches. The remaining results were analyzed for relevance. Results: Twelve Ovid MEDLINE filters were created and the challenges involved in creating them were documented. The filters increased recall by 58 articles, 464% over MeSH searches alone. Of the additional articles retrieved, 28 (100%) met the criteria for relevance. Discussion: The lists of challenges identified in the filter creation will assist other searchers in developing similar filters. The filters allow searchers to retrieve substantially more articles than is currently possible with the MeSH terms alone.

BackgroundCurrent guidelines recommend children be treated for hepatitis C virus (HCV) using the same principles applied in adults. There are however few published studies which assess the efficacy and safety of HCV therapy in children.Methodology/principal findingsA systematic review of the literature was completed for studies of any design that evaluated HCV therapy in children. The primary outcome was sustained virologic response (SVR), with sub-group analysis of response rates by genotype. There were 4 randomized controlled trials (RCTs) and 31 non-randomized studies, all involving interferon, pegylated interferon (PEG-IFN), or combinations of these drugs with ribavirin. The SVR rate could not be directly compared as the populations and interventions differed across studies. Genotype was not reported or differed substantially from study to study. The overall SVR rate for PEG-IFN and ribavirin ranged from 30 to 100% which is comparable to the rate in adults. Similar to adults, the SVR rates were significantly higher in children with genotype 2 or 3 compared to genotype 1. Adverse effects were primarily flu-like symptoms and neutropenia. There were insufficient data to assess the applicability of the week 12 stop rule (stopping therapy at week 12 if there is less than a 2 log drop in HCV RNA) or the efficacy of shortening therapy to 24 weeks in children with genotype 2 and 3.Conclusions/significanceCurrent guidelines for the treatment of HCV in children are based on limited data. Further research is needed to define the optimal therapy for HCV in children.

BACKGROUND: The objective of this study was to describe randomized controlled trials (RCTs) and controlled clinical trials (CCTs) in child health published between 1948 and 2006, in terms of quantity, methodological quality, and publication and trial characteristics. We used the Trials Register of the Cochrane Child Health Field for overall trends and a sample from this to explore trial characteristics in more detail. METHODOLOGY/PRINCIPAL FINDINGS: We extracted descriptive data on a random sample of 578 trials. Ninety-six percent of the trials were published in English; the percentage of child-only trials was 90.5%. The most frequent diagnostic categories were infectious diseases (13.2%), behavioural and psychiatric disorders (11.6%), neonatal critical care (11.4%), respiratory disorders (8.9%), non-critical neonatology (7.9%), and anaesthesia (6.5%). There were significantly fewer child-only studies (i.e., more mixed child and adult studies) over time (P = 0.0460). The proportion of RCTs to CCTs increased significantly over time (P

BackgroundMuch controversy exists regarding the clinical efficacy of behavioural and developmental interventions for improving the core symptoms of autism spectrum disorders (ASD). We conducted a systematic review to summarize the evidence on the effectiveness of behavioural and developmental interventions for ASD.Methods and findingsComprehensive searches were conducted in 22 electronic databases through May 2007. Further information was obtained through hand searching journals, searching reference lists, databases of theses and dissertations, and contacting experts in the field. Experimental and observational analytic studies were included if they were written in English and reported the efficacy of any behavioural or developmental intervention for individuals with ASD. Two independent reviewers made the final study selection, extracted data, and reached consensus on study quality. Results were summarized descriptively and, where possible, meta-analyses of the study results were conducted. One-hundred-and-one studies at predominantly high risk of bias that reported inconsistent results across various interventions were included in the review. Meta-analyses of three controlled clinical trials showed that Lovaas treatment was superior to special education on measures of adaptive behaviour, communication and interaction, comprehensive language, daily living skills, expressive language, overall intellectual functioning and socialization. High-intensity Lovaas was superior to low-intensity Lovaas on measures of intellectual functioning in two retrospective cohort studies. Pooling the results of two randomized controlled trials favoured developmental approaches based on initiative interaction compared to contingency interaction in the amount of time spent in stereotyped behaviours and distal social behaviour, but the effect sizes were not clinically significant. No statistically significant differences were found for: Lovaas versus special education for non-verbal intellectual functioning; Lovaas versus Developmental Individual-difference relationship-based intervention for communication skills; computer assisted instruction versus no treatment for facial expression recognition; and TEACCH versus standard care for imitation skills and eye-hand integration.ConclusionsWhile this review suggests that Lovaas may improve some core symptoms of ASD compared to special education, these findings are based on pooling of a few, methodologically weak studies with few participants and relatively short-term follow-up. As no definitive behavioural or developmental intervention improves all symptoms for all individuals with ASD, it is recommended that clinical management be guided by individual needs and availability of resources.