Educational attainment in patients with congenital heart disease: a comprehensive systematic review and meta-analysis.


Journal

BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539

Informations de publication

Date de publication:
19 11 2021
Historique:
received: 16 06 2021
accepted: 18 10 2021
entrez: 20 11 2021
pubmed: 21 11 2021
medline: 18 1 2022
Statut: epublish

Résumé

Our aim was to comprehensively review published evidence on the association between having a congenital heart disease (CHD) compared with not, on educational attainment (i.e. not obtaining a university degree, completing secondary education, or completing any vocational training vs. obtaining/completing) in adults. Studies were eligible if they reported the rate, odds, or proportion of level of educational attainment in adults by whether or not they had a CHD. Out of 1537 articles screened, we identified 11 (N = 104,585 participants, 10,487 with CHD), 10 (N = 167,470 participants, 11,820 with CHD), and 8 (N = 150,813 participants, 9817 with CHD) studies reporting information on university education, secondary education, and vocational training, respectively in both CHD and non-CHD participants. Compared to their non-CHD peers, CHD patients were more likely not to obtain a university degree (OR = 1.38, 95% CI [1.16, 1.65]), complete secondary education (OR = 1.33, 95% CI [1.09, 1.61]) or vocational training (OR = 1.11, 95% CI [0.98, 1.26]). For all three outcomes there was evidence of between study heterogeneity, with geographical area contributing to this heterogeneity. This systematic review identified all available published data on educational attainment in CHD patients. Despite broad inclusion criteria we identified relatively few studies that included a comparison group from the same population, and amongst those that did, few adjusted for key confounders. Pooled analyses suggest evidence of lower levels of educational attainment in patients with CHD when compared to non-CHD peers. The extent to which this may be explained by confounding factors, such as parental education, or mediated by treatments is not possible to discern from the current research literature.

Sections du résumé

BACKGROUND
Our aim was to comprehensively review published evidence on the association between having a congenital heart disease (CHD) compared with not, on educational attainment (i.e. not obtaining a university degree, completing secondary education, or completing any vocational training vs. obtaining/completing) in adults.
METHOD
Studies were eligible if they reported the rate, odds, or proportion of level of educational attainment in adults by whether or not they had a CHD.
RESULT
Out of 1537 articles screened, we identified 11 (N = 104,585 participants, 10,487 with CHD), 10 (N = 167,470 participants, 11,820 with CHD), and 8 (N = 150,813 participants, 9817 with CHD) studies reporting information on university education, secondary education, and vocational training, respectively in both CHD and non-CHD participants. Compared to their non-CHD peers, CHD patients were more likely not to obtain a university degree (OR = 1.38, 95% CI [1.16, 1.65]), complete secondary education (OR = 1.33, 95% CI [1.09, 1.61]) or vocational training (OR = 1.11, 95% CI [0.98, 1.26]). For all three outcomes there was evidence of between study heterogeneity, with geographical area contributing to this heterogeneity.
CONCLUSION
This systematic review identified all available published data on educational attainment in CHD patients. Despite broad inclusion criteria we identified relatively few studies that included a comparison group from the same population, and amongst those that did, few adjusted for key confounders. Pooled analyses suggest evidence of lower levels of educational attainment in patients with CHD when compared to non-CHD peers. The extent to which this may be explained by confounding factors, such as parental education, or mediated by treatments is not possible to discern from the current research literature.

Identifiants

pubmed: 34798837
doi: 10.1186/s12872-021-02349-z
pii: 10.1186/s12872-021-02349-z
pmc: PMC8603574
doi:

Types de publication

Journal Article Meta-Analysis Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

549

Subventions

Organisme : British Heart Foundation
ID : CH/F/20/90003
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00011/6
Pays : United Kingdom
Organisme : British Heart Foundation
ID : CH/17/1/32804
Pays : United Kingdom
Organisme : British Heart Foundation
ID : PG/15/33/31394
Pays : United Kingdom

Informations de copyright

© 2021. The Author(s).

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Auteurs

Lucia Cocomello (L)

MRC Integrative Epidemiology Unit, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK. nn18747@bristol.ac.uk.

Arnaldo Dimagli (A)

Bristol Heart Institute, Terrell St, Bristol, BS2 8 ED, UK.

Giovanni Biglino (G)

Bristol Medical School, Tyndall Avenue, Bristol, BS8 1UD, UK.
National Heart and Lung Institute, Imperial College London, London, UK.

Rosie Cornish (R)

MRC Integrative Epidemiology Unit, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

Massimo Caputo (M)

Bristol Heart Institute, Terrell St, Bristol, BS2 8 ED, UK.

Deborah A Lawlor (DA)

MRC Integrative Epidemiology Unit, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Bristol NIHR Biomedical Research Centre, Bristol, UK.

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