Systematic reviews experience major limitations in reporting absolute effects
| Autor: | Affan Irfan, Holger J. Schünemann, Matthias Briel, Kari A.O. Tikkinen, Andrea Juliana Sanabria, Ivan Solà, Per Olav Vandvik, Anggie Ramírez-Morera, Romina Brignardello-Petersen, Alfonso Iorio, Anna Selva, Qi Zhou, Shanil Ebrahim, Laura Martínez García, Gordon H. Guyatt, Brad C. Johnston, Xin Sun, Ignacio Neumann, Oscar E. Zazueta, Robin W.M. Vernooij, Carlos E Granados, Jason W. Busse, Yuqing Zhang, Alonso Carrasco-Labra, Pablo Alonso-Coello, Reem A. Mustafa, Elie A. Akl |
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| Rok vydání: | 2016 |
| Předmět: |
Quality Control
Research Report Research design Absolute effect estimates Risk difference Data Interpretation Epidemiology 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine parasitic diseases Statistics Odds Ratio Humans Medicine 030212 general & internal medicine Absolute measures business.industry Decision making Framing Reporting Systematic review Data Interpretation Statistical Delivery of Health Care Epidemiologic Studies Research Design Patient Outcome Assessment Absolute risk reduction Odds ratio Statistical Regression Confidence interval 3. Good health Clinical trial Number needed to treat business |
| Zdroj: | Journal of Clinical Epidemiology. 72:16-26 |
| ISSN: | 0895-4356 |
| Popis: | Objectives Expressing treatment effects in relative terms yields larger numbers than expressions in absolute terms, affecting the judgment of the clinicians and patients regarding the treatment options. It is uncertain how authors of systematic reviews (SRs) absolute effect estimates are reported in. We therefore undertook a systematic survey to identify and describe the reporting and methods for calculating absolute effect estimates in SRs. Study Design and Setting Two reviewers independently screened title, abstract, and full text and extracted data from a sample of Cochrane and non-Cochrane SRs. We used regression analyses to examine the association between study characteristics and the reporting of absolute estimates for the most patient-important outcome. Results We included 202 SRs (98 Cochrane and 104 non-Cochrane), most of which (92.1%) included standard meta-analyses including relative estimates of effect. Of the 202 SRs, 73 (36.1%) reported absolute effect estimates for the most patient-important outcome. SRs with statistically significant effects were more likely to report absolute estimates (odds ratio, 2.26; 95% confidence interval: 1.08, 4.74). The most commonly reported absolute estimates were: for each intervention, risk of adverse outcomes expressed as a percentage (41.1%); number needed to treat (26.0%); and risk for each intervention expressed as natural units or natural frequencies (24.7%). In 12.3% of the SRs that reported absolute effect estimates for both benefit and harm outcomes, harm outcomes were reported exclusively as absolute estimates. Exclusively reporting of beneficial outcomes as absolute estimates occurred in 6.8% of the SRs. Conclusions Most SRs do not report absolute effects. Those that do often report them inadequately, thus requiring users of SRs to generate their own estimates of absolute effects. For any apparently effective or harmful intervention, SR authors should report both absolute and relative estimates to optimize the interpretation of their findings. |
| Databáze: | OpenAIRE |
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