Urinary tract infection guidelines should address unique, specific questions and include analyses of primary data

Excerpt

Evidence-based review papers should support their key claims and recommendations by undertaking detailed reassessment of all the primary data in the form of meta-analyses. These publications should report the details of the reanalysis they have undertaken of the primary data, rather than simply quoting the conclusions that the authors reached at the time of publication. The plethora of publications relating to wide-ranging topics, such as childhood urinary tract infection (UTI), makes it a sizeable task to produce even a highly focussed single question review that will provide the reader with compellingly argued evidence-based conclusions, let alone attempt to cover the multiple issues involved. Hari et al. have attempted to review almost all aspects of diagnosis and management in their update of the Indian Society of Pediatric Nephrology UTI guidelines published 11 years ago [1], by producing an ‘Evidence-based clinical practice guideline for management of urinary tract infection and primary vesicoureteric reflux’ in this journal [2], excluding children with neuropathic bladders, obstructive uropathy, or immunocompromise. This must have been a daunting task as Embase alone lists 9397 potentially relevant publications since 2011, of which 407 were reviews and 51 were meta-analyses. …