A parable wrapped in an enigma - Population-based assessments of outcomes among high-risk neonates ave even less achievable in the age of clinical informatics

A staple of the biomedical research literature in perinatal care is the art icle on sequelae of high-risk infants. These articles variously examine gro wth, cognitive, neurodevelopment-al, behavioral, health, and other outcomes of low-birth-weight, preterm, or intrauterine growth-restricted neonates w ho survived the neonatal intensive care unit (NICU) or neonatal period. Mor e recently, a new genre of articles has emerged that provides metaanalytic or systematic reviews of the results of these articles on sequelae of high- risk infants.(1-5) A review of the purposes, analytic strategies, conclusio ns, and implications of these studies seems worthwhile. In this commentary, I focus especially on the comments and suggestions of other researchers wh o have considered the methodological complexities and study designs require d for scientifically valid, clinically useful studies.(6-10)