Individual Patient Meta-analysis in Pediatrics

Abstract

In this issue of Pediatrics , Askie et al1,2 present their report of an individual patient data (IPD) meta-analysis of randomized controlled trials of inhaled nitric oxide (iNO) in preterm infants. This article is of great interest regarding what it tells us about both IPD meta-analysis and the use of iNO in preterm infants. By now, everyone in the pediatric community is familiar with the idea of systematic reviews and meta-analyses. Most meta-analysis reports that pediatricians would have read involve aggregate data analyzed at the trials level. Meta-analyses of aggregate data are typical of Cochrane reviews. Data from these types of analyses enable us to gain greater precision regarding clinically important outcomes. Aggregate-data meta-analyses at the trials level have been used in creating policies and guidelines. Systematic reviews and meta-analyses of antenatal3 and postnatal4,5 corticosteroids have greatly influenced practice in neonatal-perinatal medicine. However, there are limitations to this analytic approach. There are … Address correspondence to Roger F. Soll, MD, University of Vermont, College of Medicine, Division of Neonatal-Perinatal Medicine, Fletcher Allen Health Care, Smith 552A, 111 Colchester Ave, Burlington, VT 05401. E-mail: roger.soll{at}vtmednet.org