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Association between type 1 diabetes mellitus and educational attainment in childhood: a systematic review protocol
  1. Natalie Jayne Oakley1,
  2. Dylan Kneale2,
  3. Mala Mann3,
  4. Mariann Hilliar4,
  5. Jeanette Tan5,
  6. Colin Dayan5,
  7. John W Gregory1,
  8. Robert French5
  1. 1 Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK
  2. 2 Social Science Research Unit (SSRU), University College London, London, UK
  3. 3 Specialist Unit for Review Evidence (SURE), Cardiff University School of Medicine, Neuadd Meirionnydd, University Hospital Wales, Cardiff, UK
  4. 4 Cardiff University Library, University Hospital Wales, Heath Park, Cardiff, UK
  5. 5 Cardiff School of Medicine, Cardiff University, University Hospital Wales, Cardiff, UK
  1. Correspondence to Dr Robert French; frenchr3{at}


Introduction Type 1 diabetes has the potential to significantly impact children’s educational attainment. With the increase in incidence, quantifying this effect would be useful to assess how much additional support should be focused on children with type 1 diabetes in school.

Methods and analysis We will conduct a systematic review of all observational studies and randomised controlled trials, including individuals both with and without a diagnosis of type 1 diabetes who have undertaken high stakes testing at the end of compulsory schooling when under 18 years of age. The search will cover both peer-reviewed and grey literature available from January 2004 to January 2018. The following seven databases will be searched: Ovid MEDLINE (1946 to present), Ovid MEDLINE Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid EMBASE (1947 to present), Thomson Reuters Web of Science, EBSCO Education Resources Information Center, EBSCO British Education Index and EBSCO Cumulative Index to Nursing and Allied Health Literature. Study selection and data extraction will be performed independently by two reviewers with any disagreements resolved via a third reviewer. The quality and risk of bias in the observational studies included in this review will be assessed using the Newcastle-Ottawa Scale. We aim to conduct a meta-analysis and will assess heterogeneity between the included studies and potential for publication bias if sufficient (>10) studies are included.

Results and dissemination Formal ethical approval is not required as individual patient data will not be collected. Results will be disseminated through peer-reviewed publication and conference presentations.

PROSPERO registration number CRD42017084078.

  • educational attainment
  • paediatric endocrinology
  • type 1 diabetes mellitus

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  • Contributors RF is the review guarantor. The concept of the review was proposed by RF and JWG, and the protocol manuscript was drafted by NJO and edited by RF, MM and JWG. The search strategy was designed by MH, NJO and RF with advice from MM. NJO, MM, JT and RF contributed to the development of the study eligibility criteria and data extraction criteria. JWG and CD provided expertise on type 1 diabetes. MM provided expertise on systematic review methodology. DK provided expertise on data extraction and meta-analysis. All authors read, edited and approved the final manuscript.

  • Funding This research was supported in part by the MRC grant MR/N015428/1.

  • Competing interests RF has received a grant from the Medical Research Council MR/N015428/1 for his work as principal investigator of the project ‘Investigating the inter-relationship between diabetes and children’s educational achievement’.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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