Sex based subgroup differences in randomized controlled trials: empirical evidence from Cochrane meta-analyses
| Autor: | Avenell, A., Robertson, C., Boachie, B., Stewart, F., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, Edwin |
|---|---|
| Přispěvatelé: | Public Health |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
Lung Neoplasms MEDLINE 030204 cardiovascular system & hematology computer.software_genre law.invention 03 medical and health sciences Benzodiazepines 0302 clinical medicine Sex Factors Randomized controlled trial Bias law Statistical significance Outcome Assessment Health Care Forest plot Medicine Humans Clinical significance Carotid Stenosis 030212 general & internal medicine Randomized Controlled Trials as Topic Endarterectomy Carotid business.industry Incidence General Medicine Risperidone 3. Good health Prolactin Hyperprolactinemia Stroke Systematic review Olanzapine Meta-analysis Female Biological plausibility Data mining business computer Demography |
| Zdroj: | BMJ-British medical journal, 355:i5826. BMJ Publishing Group |
| ISSN: | 0959-8146 1756-1833 |
| Popis: | Objective To evaluate the frequency, validity, and relevance of statistically significant (P Design Meta-epidemiological study. Data sources Cochrane Database of Systematic Reviews (CDSR) and PubMed. Eligibility criteria for study selection Reviews published in the CDSR with sex-treatment subgroup analyses in the forest plots, using data from randomized controlled trials. Data extraction Information on the study design and sex subgroup data were extracted from reviews and forest plots that met inclusion criteria. For each statistically significant sex-treatment interaction, the potential for biological plausibility and clinical significance was considered. Results Among the 41 reviews with relevant data, there were 109 separate treatment-outcome analyses (“topics”). Among the 109 topics, eight (7%) had a statistically significant sex-treatment interaction. The 109 topics included 311 randomized controlled trials (162 with both sexes, 46 with males only, 103 with females only). Of the 162 individual randomized controlled trials that included both sexes, 15 (9%) had a statistically significant sex-treatment interaction. Of four topics where the first published randomized controlled trial had a statistically significant sex-treatment interaction, no meta-analyses that included other randomized controlled trials retained the statistical significance and no meta-analyses showed statistical significance when data from the first published randomized controlled trial were excluded. Of the eight statistically significant sex-treatment interactions from the overall analyses, only three were discussed by the CDSR reviewers for a potential impact on different clinical management for males compared with females. None of these topics had a sex-treatment interaction that influenced treatment recommendations in recent guidelines. UpToDate, an online physician-authored clinical decision support resource, suggested differential management of men and women for one of these sex-treatment interactions. Conclusion Statistically significant sex-treatment interactions are only slightly more frequent than what would be expected by chance and there is little evidence of subsequent corroboration or clinical relevance of sex-treatment interactions. |
| Databáze: | OpenAIRE |
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