A Systematic Review and Meta-Analysis of Intensive Multidisciplinary Intervention for Pediatric Feeding Disorders: How Standard Is the Standard of Care?. Sharp W.G., Volkert V.M., Scahill L., McCracken C.E., & McElhanon B. 2017.
A Systematic Review and Meta-Analysis of Intensive Multidisciplinary Intervention for Pediatric Feeding Disorders: How Standard Is the Standard of Care? [link]Paper  abstract   bibtex   
Objective To assess models of care and conduct a meta-analysis of program outcomes for children receiving intensive, multidisciplinary intervention for pediatric feeding disorders. Study design We searched Medline, PsycINFO, and PubMed databases (2000-2015) in peer-reviewed journals for studies that examined the treatment of children with chronic food refusal receiving intervention at day treatment or inpatient hospital programs. Inclusion criteria required the presentation of quantitative data on food consumption, feeding behavior, and/or growth status before and after intervention. Effect size estimates were calculated based on a meta-analysis of proportions. Results The systematic search yielded 11 studies involving 593 patients. Nine articles presented outcomes based on retrospective (nonrandomized) chart reviews; 2 studies involved randomized controlled trials. All samples involved children with complex medical and/or developmental histories who displayed persistent feeding concerns requiring formula supplementation. Behavioral intervention and tube weaning represented the most common treatment approaches. Core disciplines overseeing care included psychology, nutrition, medicine, and speech-language pathology/occupational therapy. The overall effect size for percentage of patients successfully weaned from tube feeding was 71% (95% CI 54%-83%). Treatment gains endured following discharge, with 80% of patients (95% CI 66%-89%) weaned from tube feeding at last follow-up. Treatment also was associated with increased oral intake, improved mealtime behaviors, and reduced parenting stress. Conclusions Results indicate intensive, multidisciplinary treatment holds benefits for children with severe feeding difficulties. Future research must address key methodological limitations to the extant literature, including improved measurement, more comprehensive case definitions, and standardization/examination of treatment approach. Copyright © 2016 Elsevier Inc.
@misc{sharp_w.g._systematic_2017,
	title = {A {Systematic} {Review} and {Meta}-{Analysis} of {Intensive} {Multidisciplinary} {Intervention} for {Pediatric} {Feeding} {Disorders}: {How} {Standard} {Is} the {Standard} of {Care}?},
	url = {http://www.elsevier.com/inca/publications/store/6/2/3/3/1/1/index.htt},
	abstract = {Objective To assess models of care and conduct a meta-analysis of program outcomes for children receiving intensive, multidisciplinary intervention for pediatric feeding disorders. Study design We searched Medline, PsycINFO, and PubMed databases (2000-2015) in peer-reviewed journals for studies that examined the treatment of children with chronic food refusal receiving intervention at day treatment or inpatient hospital programs. Inclusion criteria required the presentation of quantitative data on food consumption, feeding behavior, and/or growth status before and after intervention. Effect size estimates were calculated based on a meta-analysis of proportions. Results The systematic search yielded 11 studies involving 593 patients. Nine articles presented outcomes based on retrospective (nonrandomized) chart reviews; 2 studies involved randomized controlled trials. All samples involved children with complex medical and/or developmental histories who displayed persistent feeding concerns requiring formula supplementation. Behavioral intervention and tube weaning represented the most common treatment approaches. Core disciplines overseeing care included psychology, nutrition, medicine, and speech-language pathology/occupational therapy. The overall effect size for percentage of patients successfully weaned from tube feeding was 71\% (95\% CI 54\%-83\%). Treatment gains endured following discharge, with 80\% of patients (95\% CI 66\%-89\%) weaned from tube feeding at last follow-up. Treatment also was associated with increased oral intake, improved mealtime behaviors, and reduced parenting stress. Conclusions Results indicate intensive, multidisciplinary treatment holds benefits for children with severe feeding difficulties. Future research must address key methodological limitations to the extant literature, including improved measurement, more comprehensive case definitions, and standardization/examination of treatment approach. Copyright © 2016 Elsevier Inc.},
	journal = {Journal of Pediatrics},
	author = {{Sharp W.G.} and {Volkert V.M.} and {Scahill L.} and {McCracken C.E.} and {McElhanon B.}},
	year = {2017},
	keywords = {*child nutrition, *childhood disease/rh [Rehabilitation], *childhood disease/th [Therapy], *enteric feeding, *feeding behavior, *feeding difficulty, *feeding disorder/rh [Rehabilitation], *feeding disorder/th [Therapy], *health care quality, *treatment outcome, *weaning, Child, Medline, PsycINFO, article, clinical outcome, controlled study, effect size, enteric feeding, follow up, food intake, health program, hospital patient, hospitalization, human, human tissue, ideal body weight, medical record review, medicine, meta analysis, model, nutritional counseling, nutritional health, occupational therapy, parental stress, pediatric rehabilitation, priority journal, quantitative study, randomized controlled trial (topic), reinforcement, speech and language rehabilitation, speech disorder, standardization, study design, systematic review, weight reduction}
}

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