In Reply We thank Zhang and Niu and Aghai for their interest in our systematic review of use of the early-onset sepsis (EOS) calculator. Zhang and Niu worry about study heterogeneity and publication bias. We carefully assessed all 13 included studies and found it appropriate to meta-analyze the 6 studies reporting data before and after EOS calculator implementation with comparable settings in both epochs.1 We grouped these studies based on their inclusion criteria; 4 studies including all newborns and 2 studies only including newborns exposed to maternal chorioamnionitis. We found no evidence of heterogeneity within studies including newborns regardless of exposure to chorioamnionitis (I2 = 0%, Figure 2). Heterogeneity in the chorioamnionitis-exposed subgroup was transparent because it contained only 2 studies.
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Achten NB, Klingenberg C, Plötz FB. Neonatal Early-Onset Sepsis Calculator and Antibiotic Therapy—Reply. JAMA Pediatr. 2020;174(5):508–509. doi:10.1001/jamapediatrics.2019.6269
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