Background: Despite possibly higher risk of severe outcomes from COVID-19 among people with intellectual and developmental disabilities (IDD), there has been limited reporting of COVID-19 trends for this population.Objective: To compare COVID-19 trends among people with and without IDD, overall and stratified by age. Methods: Data from the TriNetX COVID-19 Research Network platform was used to identify COVID-19 patients. Analysis focused on trends in comorbidities, number of cases, number of deaths, and casefatality rate among patients with and without IDD who had a positive diagnosis for COVID-19 through May 14, 2020. Results: People with IDD had higher prevalence of specific comorbidities associated with poorer COVID-19 outcomes. Distinct age-related differences in COVID-19 trends were present among those with IDD, with a higher concentration of COVID-19 cases at younger ages. In addition, while the overall casefatality rate was similar for those with IDD (5.1%) and without IDD (5.4%), these rates differed by age: ages 17 e IDD 1.6%, without IDD <0.01%; ages 18e74 e IDD 4.5%, without IDD 2.7%; ages 75e IDD 21.1%, without IDD, 20.7%. Conclusions: Though of concern for all individuals, COVID-19 appears to present a greater risk to people with IDD, especially at younger ages. Future research should seek to document COVID-19 trends among people with IDD, with particular attention to age related trends.
Aim
To evaluate the methodological quality of recent systematic reviews of interventions for children with cerebral palsy in order to determine the level of confidence in the reviews’ conclusions.
Method
A comprehensive search of 22 databases identified eligible systematic reviews with and without meta‐analysis published worldwide from 2015 to 2019. We independently extracted data and used A Measurement Tool to Assess Systematic Reviews‐2 (AMSTAR‐2) to appraise methodological quality.
Results
Eighty‐three systematic reviews met strict eligibility criteria. Most were from Europe and Latin America and reported on rehabilitative interventions. AMSTAR‐2 appraisal found critically low confidence in 88% (n=73) because of multiple and varied deficiencies. Only 7% (n=6) had no AMSTAR‐2 critical domain deficiency. The number of systematic reviews increased fivefold from 2015 to 2019; however, quality did not improve over time.
Interpretation
Most of these systematic reviews are considered unreliable according to AMSTAR‐2. Current recommendations for treating children with CP based on these flawed systematic reviews need re‐evaluation. Findings are comparable to reports from other areas of medicine, despite the general perception that systematic reviews are high‐level evidence. The required use of current widely accepted guidance for conducting and reporting systematic reviews by authors, peer reviewers, and editors is critical to ensure reliable, unbiased, and transparent systematic reviews.
Confidence was critically low in the conclusions of 88% of systematic reviews about interventions for children with cerebral palsy (CP).
Quality issues in the sample were not limited to systematic reviews of non‐randomized trials, or to those about certain populations of CP or interventions.
The inclusion of meta‐analysis did not improve the level of confidence in these systematic reviews.
Numbers of systematic reviews on this topic increased over the 5 search years but their methodological quality did not improve.
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