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Cochrane Database of Systematic Reviews

Protein hydrolysate versus standard formula for preterm infants

Overview of attention for article published in Cochrane database of systematic reviews, October 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (93rd percentile)
  • High Attention Score compared to outputs of the same age and source (80th percentile)

Mentioned by

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60 tweeters
facebook
5 Facebook pages
googleplus
1 Google+ user

Citations

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12 Dimensions

Readers on

mendeley
97 Mendeley
Title
Protein hydrolysate versus standard formula for preterm infants
Published in
Cochrane database of systematic reviews, October 2017
DOI 10.1002/14651858.cd012412.pub2
Pubmed ID
Authors

Derek Hang Cheong Ng, Joel Klassen, Nicholas D Embleton, William McGuire

Abstract

When human milk is not available for feeding preterm infants, protein hydrolysate rather than standard cow's milk formulas (with intact proteins) are often used because they are perceived as being tolerated better and less likely to lead to complications. However, protein hydrolysate formulas are more expensive than standard formulas, and concern exists that their use in practice is not supported by high-quality evidence. To assess the effect of feeding preterm infants with hydrolysed formula (versus standard cow's milk formulas) on the risk of feed intolerance, necrotising enterocolitis, and other morbidity and mortality in preterm infants. We used the standard Cochrane Neonatal search strategy including electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 4), Ovid MEDLINE, Ovid Embase, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (to April 2017), as well as conference proceedings and previous reviews. Randomised and quasi-randomised controlled trials that compared feeding preterm infants with protein hydrolysate versus standard (non-hydrolysed) cow's milk formula. Two review authors assessed trial eligibility and risk of bias and extracted data independently. We analysed treatment effects as described in the individual trials and reported risk ratios and risk differences for dichotomous data, and mean differences for continuous data, with respective 95% confidence intervals (CI). We used a fixed-effect model in meta-analyses and explored potential causes of heterogeneity in sensitivity analyses. We assessed quality of evidence at the outcome level using the GRADE approach. We identified 11 trials for inclusion in the review. All trials were small (total participants 665) and had various methodological limitations including uncertainty about methods to ensure allocation concealment and blinding. Most participants were clinically stable preterm infants of gestational age less than about 34 weeks or birth weight less than about 1750 g. Fewer participants were extremely preterm, extremely low birth weight, or growth-restricted. Most trials found no effects on feed intolerance assessed variously as mean prefeed gastric residual volume, incidence of abdominal distention or other concerning gastrointestinal signs, or time taken to achieve full enteral feeds (meta-analysis was limited because studies used different measures). Meta-analysis found no effect on the risk of necrotising enterocolitis (typical risk ratio 1.10, 95% CI 0.36 to 3.34; risk difference 0.00, 95% CI -0.03 to 0.04; 5 trials, 385 infants) (low quality evidence; downgraded for imprecision and design weaknesses). The identified trials provide only low quality evidence about the effects of feeding preterm infants with protein hydrolysate versus standard formula. The existing data did not support conclusions that feeding with protein hydrolysate affects the risk of feed intolerance or necrotising enterocolitis. Further large, pragmatic trials are needed to provide more reliable and precise estimates of effectiveness and cost-effectiveness.

Twitter Demographics

The data shown below were collected from the profiles of 60 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 97 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 97 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 14 14%
Student > Master 14 14%
Student > Bachelor 14 14%
Student > Ph. D. Student 5 5%
Other 4 4%
Other 17 18%
Unknown 29 30%
Readers by discipline Count As %
Medicine and Dentistry 19 20%
Nursing and Health Professions 13 13%
Agricultural and Biological Sciences 7 7%
Pharmacology, Toxicology and Pharmaceutical Science 5 5%
Biochemistry, Genetics and Molecular Biology 5 5%
Other 12 12%
Unknown 36 37%

Attention Score in Context

This research output has an Altmetric Attention Score of 37. 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 26 February 2020.
All research outputs
#786,932
of 20,032,353 outputs
Outputs from Cochrane database of systematic reviews
#1,840
of 12,011 outputs
Outputs of similar age
#19,255
of 294,188 outputs
Outputs of similar age from Cochrane database of systematic reviews
#51
of 262 outputs
Altmetric has tracked 20,032,353 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 12,011 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 27.9. This one has done well, scoring higher than 84% of its peers.
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 294,188 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 93% of its contemporaries.
We're also able to compare this research output to 262 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 80% of its contemporaries.