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Surgery versus non‐surgical management for unilateral ureteric‐pelvic junction obstruction in newborns and infants less than two years of age

Overview of attention for article published in Cochrane database of systematic reviews, July 2016
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  • Good Attention Score compared to outputs of the same age (69th percentile)

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Title
Surgery versus non‐surgical management for unilateral ureteric‐pelvic junction obstruction in newborns and infants less than two years of age
Published in
Cochrane database of systematic reviews, July 2016
DOI 10.1002/14651858.cd010716.pub2
Pubmed ID
Authors

Marcus Weitz, Suniva Portz, Guido F Laube, Joerg J Meerpohl, Dirk Bassler

Abstract

Unilateral ureteric-pelvic junction obstruction (UPJO) is the most common cause of obstructive uropathy and may lead to renal impairment and loss of renal function. The current diagnostic approach with renal imaging cannot reliably determine which newborns and infants less than two years of age have a significant obstruction and are at risk for permanent kidney damage. There is therefore no consensus on optimal therapeutic management of unilateral UPJO. To assess the effects of surgical versus non-surgical treatment options for newborns and infants less than two years of age with unilateral UPJO. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 6, 2016), MEDLINE/Ovid, and EMBASE/Ovid databases from their inception to 13 June 2016. We searched the reference lists of potentially relevant studies without using any language restriction. We also searched the following trial registers for relevant registered studies: www.clinicaltrials.gov/; ISRCTN registry (controlled-trials.com/); www.trialscentral.org/; apps.who.int/trialsearch/; www.drks.de/; and www.anzctr.org.au/trialSearch.aspx. We selected randomised and quasi-randomised controlled trials comparing surgical with non-surgical interventions for the treatment of unilateral UPJO. Two review authors independently assessed study eligibility and risk of bias of included studies and extracted data. In case of disagreements we consulted a third review author. The data reported in the two included studies did not allow us to perform a meta-analysis. We found only two studies at high risk of bias that were eligible for inclusion in this review. The total sample size, including both trials, was small (n = 107 participants less than six months of age from the UK and USA), and not all prespecified outcome measures were assessed. Reported measures only accounted for the short-term follow-ups. The mean split renal function was not statistically different between the surgical and non-surgical group at the six-month or one-year time point (very low-quality evidence). The surgical group showed a significantly less obstructed drainage pattern and a lower urinary tract dilatation than the non-surgical group (very low-quality evidence). Transfer from the non-surgical group to the surgical group was reported for about one out of five participants. Split renal function after secondary surgical intervention was reported with variable results, but most of the participants reverted to pre-deteriorated values. The studies either provided no or insufficient data on the following outcome measures: postoperative complications, UPJO-associated clinical symptoms, costs of interventions, radiation exposure, quality of life, and adverse effects. We found limited evidence assessing the benefits and harms of surgical compared to non-surgical treatment options for newborns and infants less than two years of age with unilateral UPJO. The majority of participants in the non-surgical treatment group did not experience any significant deterioration of split renal function, and only about 20% of them underwent secondary surgical intervention, with minor risk of permanent deteriorated split renal function. The study follow-up period was too short to assess the long-term effects on split renal function in both treatment groups. We need further randomised controlled trials with sufficient statistical power and an adequate follow-up period to determine the optimal therapy for newborns and infants less than two years of age with unilateral UPJO.

X Demographics

X Demographics

The data shown below were collected from the profiles of 7 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 125 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Denmark 1 <1%
Unknown 124 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 16 13%
Student > Bachelor 16 13%
Researcher 12 10%
Other 7 6%
Student > Postgraduate 7 6%
Other 20 16%
Unknown 47 38%
Readers by discipline Count As %
Medicine and Dentistry 36 29%
Nursing and Health Professions 17 14%
Psychology 6 5%
Social Sciences 4 3%
Pharmacology, Toxicology and Pharmaceutical Science 3 2%
Other 9 7%
Unknown 50 40%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 31 January 2017.
All research outputs
#7,179,476
of 25,457,858 outputs
Outputs from Cochrane database of systematic reviews
#8,275
of 11,842 outputs
Outputs of similar age
#112,183
of 371,157 outputs
Outputs of similar age from Cochrane database of systematic reviews
#155
of 208 outputs
Altmetric has tracked 25,457,858 research outputs across all sources so far. This one has received more attention than most of these and is in the 71st percentile.
So far Altmetric has tracked 11,842 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 38.9. This one is in the 27th percentile – i.e., 27% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 371,157 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.
We're also able to compare this research output to 208 others from the same source and published within six weeks on either side of this one. This one is in the 25th percentile – i.e., 25% of its contemporaries scored the same or lower than it.