Quality appraisal of systematic reviews of interventions for children with cerebral palsy reveals critically low confidence.

Most of these systematic reviews are considered unreliable according to AMSTAR-2. Current recommendations for treating children with CP based on these flawed systematic reviews need re-evaluation. Findings are comparable to reports from other areas of medicine, despite the general perception that systematic reviews are high-level evidence. The required use of current widely accepted guidance for conducting and reporting systematic reviews by authors, peer reviewers, and editors is critical to ensure reliable, unbiased, and transparent systematic reviews. What this paper adds Confidence was critically low in the conclusions of 88% of systematic reviews about interventions for children with cerebral palsy (CP). Quality issues in the sample were not limited to systematic reviews of non-randomized trials, or to those about certain populations of CP or interventions. The inclusion of meta-analysis did not improve the level of confidence in these systematic reviews. Numbers of systematic reviews on this topic increased over the 5 search years but their methodological quality did not improve.