Developmental outcomes after early surgery for complex congenital heart disease: a systematic review and meta‐analysis

Figures

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  Figure 1. Meta‐analyses of Bayley Psychomotor Developmental Index (PDI) and Mental Developmental Index (MDI). Forest plots of (a) PDI, (b) MDI. The studies are listed by the author’s last name and year, and ranked according to methodological quality (high at the top). The black boxes indicate the means, the lines the confidence intervals (CIs), and the dotted lines the prediction intervals. The black diamond indicates the estimated means from the random‐effects (RE) meta‐analysis. Heterogeneity remained: (PDI: τ 2 =49.47 [p<0.001], I 2 =94%; MDI: τ 2 =34.03 [p<0.001]). I 2 =89%). (c) Bubble plot regression graph of the association between surgery era and mean PDI of the individual studies. The symbol sizes are related to the weights of the studies in the analysis; larger diamonds indicate larger/more precise studies. Based on the meta‐regression RE model with adjustment for age, the predicted average mean PDI as a function of the covariate period (with age fixed at 21mo) is also added to the plot (line) with 95% CI (dotted lines). Surgery era code is indicated as the median year of the surgery period. (d) Bubble plot regression graph of the association between assessment age of the infant…

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  Figure 2. Meta‐analyses of IQ scores. (a–c) Forest plots of full‐scale IQ, verbal IQ, and performance IQ respectively. The studies are listed by the author’s last name and year, and ranked according to methodological quality (high at the top). The black boxes indicate the means, the lines the confidence intervals, and the dotted lines the prediction intervals. The black diamond indicates the estimated means from the random‐effects (RE) meta‐analysis. Heterogeneity remained: (full‐scale IQ: τ 2=9.21 [p<0.001], I 2=70.3%; verbal IQ: τ 2 =11.2 [p<0.001], I 2=75.7%; performance IQ: τ 2=14.1 [p<0.001], I 2 =80.4%). (d–f) Bubble plot regression graphs of the association between assessment age of the child and full‐scale IQ, verbal IQ, and performance IQ respectively. (g–i) Bubble plot regression graphs of the association between surgery era and full‐scale IQ, verbal IQ, and performance IQ respectively. For explanation, see the description of Figure 1.