In Reply We thank the authors of the letters for their correspondence and interest in our meta-analysis of the prevalence of anxiety and depression in children, adolescents, and young adults with life-limiting conditions (LLCs).1 One of the key issues highlighted in these letters was heterogeneity, both in the overall meta-analysis and the subgroup analyses. Although we agree that the heterogeneity is high, we do not believe that this is a methodologic flaw but is instead an important finding of the review. The objective of the meta-analysis was to pool prevalence data to understand the epidemiology of anxiety and depression in the total population because palliative care services are involved in the care and support of all patients in this population. In addition, previous meta-analyses of prevalence found similarly high heterogeneity, both in their overall analysis2,3 and subgroup analysis.3 We also agree that caution should be taken when interpreting the results of the meta-regression, as with any meta-analysis, because many studies could not be included in this analysis owing to the lack of reporting of key study characteristics. It is noted in the conclusion of our meta-analysis that future studies should report data separately by sex and age band to comprehensively evaluate the effects of these covariates on anxiety and depression prevalence.1
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Barker MM, Bland M, Fraser LK. Anxiety and Depression Prevalence in Children, Adolescents, and Young Adults With Life-Limiting Conditions—Reply. JAMA Pediatr. 2020;174(2):208–209. doi:10.1001/jamapediatrics.2019.4809
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: