Aim To evaluate the use of the three standard definitions of sudden infant death syndrome (SIDS) in the contemporary literature. Methods A search was undertaken of the US National Library of Medicine ‘PubMed’ database for all research articles listed under ‘sudden infant death syndrome’ or ‘SIDS’, from 2019 to 2021 accessible through the University of Adelaide library. Results 564 papers had keywords ‘sudden infant death syndrome’ or ‘SIDS’. 300 papers were not included in the study as they were not written in English, SIDS was not the primary focus, publishing was in predatory journals, or they were Letters to the Editor, commentaries, technical reports, reviews or editorials. The remaining 264 papers consisted of 172 papers without a standard definition, including reports without definitions, with idiosyncratic or incorrectly quoted definitions or with incorrect referencing (65%), and 92 with one of the three standard definitions either quoted in full in the text or correctly referenced (35%). Conclusion Nearly two‐thirds of peer‐reviewed publications on SIDS listed on PubMed over the past three years have not quoted or referenced accepted definitions. Interpreting research conclusions and monitoring trends in SIDS mortality will be extremely difficult if different population subgroups are being targeted by different research groups.
Changes in infant and early childhood mortality have occurred over the years with initiatives such as proper sewage disposal and immunizations having a dramatic effect on the incidence of infectious diseases such as gastroenteritis, measles, rubella and mumps, to name but a few. In more recent years, in Western countries in particular, the 'Reduce the Risks' campaigns aimed at decreasing exposure of infants to risk factors for sudden infant death syndrome (SIDS) such as prone sleeping and cigarette smoke exposure have been associated with dramatic falls in the incidence of this entity. 1,2 The identification and avoidance of unsafe sleeping environments has also been a focus for several decades now with the characteristics of dangerous cribs (cots) and sleeping situations being clearly delineated. 3,4 Unfortunately, however, the separation of deaths due to SIDS from those caused by accidental asphyxia may not always be possible. 5 Despite this there has been a fall in the number of cases of sleeping accidents due to mechanically unsafe
Plus ça change, plus c'est la même chose" -the more things change, the more they stay the same. Jean-Baptiste Alphonse Karr (1808-1890) Calls for a standardised definition and approaches to the investigation of unexpected infant death have been made for decades. 1,2 It is now 20 years since an expert committee was convened in San Diego by Dr Henry Krous under the auspices of the CJ Foundation for SIDS (in January 2004) to examine the then current definitions of sudden infant death syndrome (SIDS) and to propose amendments. In 2023 it seems an appropriate time to evaluate the impact (or not) of this meeting. The San Diego meeting participants, who included paediatric and forensic pathologists and paediatricians, were tasked with developing a new general definition for administrative and vital statistics purposes. Stratification of cases was undertaken specifically 'to facilitate research into sudden infant death'. A category of unclassified sudden infant deaths (USID) was also proposed for cases not meeting the criteria for SIDS and for which 'alternative diagnoses of natural or unnatural conditions were equivocal'. 3 The meeting lasted for 2 days and the participants agreed upon what was to be subsequently known as the San Diego definition, which built upon, and superseded, the Seattle definition of 1969 4
Aim: To determine the percentage of published reports that used one of the three standard definitions of sudden infant death syndrome (SIDS). Methods: 100 original research articles or reviews listed under 'sudden infant death syndrome' on PubMed were allocated into two groups: (a) those where a standard definition had not been cited, including those without definitions, with idiosyncratic or incorrect definitions, or with incorrect referencing, and (b) those where one of the standard definitions was either correctly cited in the text and/or was correctly referenced. Results: 89% did not use any, or quoted/cited/referenced a nonstandard, definition. Of the remaining 11, 9 both quoted a standard definition in the text and correctly referenced it. The remainder either quoted a standard reference in the text or correctly referenced it. Conclusion: On preliminary analysis of an initial 100 papers, only 9% of papers on SIDS in the contemporary literature both correctly quoted and referenced one of the three standard internationally-accepted definitions. A full 89% had used either no or an idiosyncratic definition with incorrect references. Clearly, the lack of adherence to standard definitions makes interpretation and comparison of studies difficult. The subsequent citation of such papers only further compounds the confusion.
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