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The Evidence Paradox of the Effectiveness between the Paediatric and Adult Stone-Forming Population: A Narrative Review.
Urol Int. 2019; 102(2):125-130.UI

Abstract

AIM/OBJECTIVE

To identify trends in the evidence base regarding the effectiveness of using α-blockers in children versus adults and compare outcomes.

METHODS

A literature search up using the key words including urolithiasis/renal/ureteric stone in children/paediatric population, medical expulsive treatment (MET), α-blocker/alfuzosin/tamsulosin/doxazosin. Included were randomized or controlled clinical trials in paediatric stone formers (aged ≤18 years). Outcome measures for assessment included the overall stone expulsion rate, expulsion time, the number of pain episodes and adverse drug effects and/or reactions. Further comparison of efficacy levels using respective studies from the adult population was performed in order to identify trends, similarities and differences.

RESULTS

A total of 8,259 articles were identified. Full text evaluation was possible for 28 articles. Although the picture is clearer in the paediatric group, the lack of reproducible results in adults certainly poses serious questions about data collection, analysis and interpretation in each individual study. The apparent paradox is due to the methodological differences between studies.

CONCLUSION

The effectiveness of α-blockers and other medication as MET needs to be studied in multi-institutional, double-blind, placebo-controlled studies that would aim to prove superiority to placebo in contemporary clinical situations, with realistic end points and standardized outcome measure determination.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Systematic Review

Language

eng

PubMed ID

30669141

Citation

Bourdoumis, Andreas, et al. "The Evidence Paradox of the Effectiveness Between the Paediatric and Adult Stone-Forming Population: a Narrative Review." Urologia Internationalis, vol. 102, no. 2, 2019, pp. 125-130.
Bourdoumis A, Durner L, Füllhase C, et al. The Evidence Paradox of the Effectiveness between the Paediatric and Adult Stone-Forming Population: A Narrative Review. Urol Int. 2019;102(2):125-130.
Bourdoumis, A., Durner, L., Füllhase, C., Dräger, D., Hakenberg, O. W., & Buchholz, N. (2019). The Evidence Paradox of the Effectiveness between the Paediatric and Adult Stone-Forming Population: A Narrative Review. Urologia Internationalis, 102(2), 125-130. https://doi.org/10.1159/000455157
Bourdoumis A, et al. The Evidence Paradox of the Effectiveness Between the Paediatric and Adult Stone-Forming Population: a Narrative Review. Urol Int. 2019;102(2):125-130. PubMed PMID: 30669141.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Evidence Paradox of the Effectiveness between the Paediatric and Adult Stone-Forming Population: A Narrative Review. AU - Bourdoumis,Andreas, AU - Durner,Leopold, AU - Füllhase,Claudius, AU - Dräger,Desiree, AU - Hakenberg,Oliver W, AU - Buchholz,Noor, Y1 - 2019/01/23/ PY - 2016/04/04/received PY - 2016/12/13/accepted PY - 2019/1/23/pubmed PY - 2019/7/25/medline PY - 2019/1/23/entrez KW - Medical expulsive treatment KW - Pediatric population KW - α-Blocker/alfuzosin/tamsulosin/doxazosin SP - 125 EP - 130 JF - Urologia internationalis JO - Urol. Int. VL - 102 IS - 2 N2 - AIM/OBJECTIVE: To identify trends in the evidence base regarding the effectiveness of using α-blockers in children versus adults and compare outcomes. METHODS: A literature search up using the key words including urolithiasis/renal/ureteric stone in children/paediatric population, medical expulsive treatment (MET), α-blocker/alfuzosin/tamsulosin/doxazosin. Included were randomized or controlled clinical trials in paediatric stone formers (aged ≤18 years). Outcome measures for assessment included the overall stone expulsion rate, expulsion time, the number of pain episodes and adverse drug effects and/or reactions. Further comparison of efficacy levels using respective studies from the adult population was performed in order to identify trends, similarities and differences. RESULTS: A total of 8,259 articles were identified. Full text evaluation was possible for 28 articles. Although the picture is clearer in the paediatric group, the lack of reproducible results in adults certainly poses serious questions about data collection, analysis and interpretation in each individual study. The apparent paradox is due to the methodological differences between studies. CONCLUSION: The effectiveness of α-blockers and other medication as MET needs to be studied in multi-institutional, double-blind, placebo-controlled studies that would aim to prove superiority to placebo in contemporary clinical situations, with realistic end points and standardized outcome measure determination. SN - 1423-0399 UR - https://www.unboundmedicine.com/medline/citation/30669141/The_Evidence_Paradox_of_the_Effectiveness_between_the_Paediatric_and_Adult_Stone-Forming_Population:_A_Narrative_Review L2 - https://www.karger.com?DOI=10.1159/000455157 DB - PRIME DP - Unbound Medicine ER -