Meta-analysis topic ideas in paediatrics and neonatology

Children are under-represented in clinical trials, so many treatments are used on adult evidence alone. That makes paediatrics a rich source of review topics: the trials that do exist are often small, and nobody has pooled them.

Neonatology is a special case. It has large, well-known trials in preterm infants and also many narrow questions about a single intervention in a specific gestational age group.

Find a paediatrics and neonatology topic that has not been done

SynthGap searches the published literature, checks each candidate against existing systematic reviews, and proposes topics with the primary studies behind them. The free plan includes 3 discovery runs a month.

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Where gaps tend to hide in paediatrics

Treatments used off-label

Drugs given to children on the basis of adult data are a classic gap: look for small paediatric trials of the same drug.

Specific age groups

Evidence for infants, school-age children and adolescents is often mixed together, so a review restricted to one age band can be new.

Long-term follow-up

Neurodevelopmental outcomes at 18 to 24 months or later are measured in only some trials and are a common missing piece.

Low- and middle-income settings

Interventions for diarrhoea, pneumonia, malnutrition and neonatal care are tested in settings where the baseline risks differ from high-income countries.

Behavioural and school-based interventions

These are studied in cluster trials that are hard to compare, so well-defined reviews can still be missing.

Outcomes and effect measures that pool well in paediatrics

Mortality and major morbidity in neonates: risk ratios. Composite outcomes such as death or bronchopulmonary dysplasia are common, so also report the components.
Growth: z-scores, mean difference, with the reference standard stated.
Neurodevelopmental impairment: usually a dichotomised outcome at a stated age. Definitions and tests (for example Bayley scales) vary, so report them.
Infection and hospitalisation: risk ratios over a stated period.
Parent-reported and behavioural scores: standardised mean difference.

Common traps in paediatric reviews

Mixing age groups or gestational ages whose baseline risk is very different.
Cluster-randomized trials (schools, villages, clinics) must be adjusted for clustering. The Cochrane Handbook explains how to apply a design effect, and ignoring it overstates precision.
Outcome definitions that changed over time, such as bronchopulmonary dysplasia.
High loss to follow-up in long-term outcomes.

Check before you commit

Before committing months to a topic, check that nobody has beaten you to it. Search PubMed with its systematic review filter, the Cochrane Library, the PROSPERO register (for reviews that are registered but not yet published) and Epistemonikos. Look at how recent the latest review is and whether new trials have appeared since its search date. Step-by-step guide.

Starting points to try in SynthGap

These are areas to explore, not claims that they are open. Some may already be well covered, and finding that out quickly is the point.

Probiotics for preventing necrotising enterocolitis in preterm infants of a specific birth weight
Oral rehydration solution formulations for children with acute diarrhoea
School-based programmes to prevent anxiety in children

Questions

Why is paediatrics a good field for new review topics?

Many treatments have only small paediatric trials, so pooling them can add real information. Check that no review of the same intervention in the same age group already exists.

Do I need a core outcome set?

It helps. The COMET initiative lists agreed sets of outcomes for many child health conditions, and using them makes your review easier to compare with others.

How do I handle cluster trials?

Adjust their sample size using a design effect, or use the cluster-adjusted estimate if the authors report one. Do not treat clustered participants as independent.

Other specialties

This page is general methodological guidance, not medical advice, and it does not list specific unreviewed topics. SynthGap's suggestions are AI-generated from the published literature, so verify them before registering a protocol.