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Systematic reviews experience major limitations in reporting absolute effects.
Alonso-Coello, Pablo; Carrasco-Labra, Alonso; Brignardello-Petersen, Romina; Neumann, Ignacio; Akl, Elie A; Vernooij, Robin W M; Johnston, Brad C; Sun, Xin; Briel, Matthias; Busse, Jason W; Ebrahim, Shanil; Granados, Carlos E; Iorio, Alfonso; Irfan, Affan; Martínez García, Laura; Mustafa, Reem A; Ramírez-Morera, Anggie; Selva, Anna; Solà, Ivan; Sanabria, Andrea Juliana; Tikkinen, Kari A O; Vandvik, Per Olav; Zazueta, Oscar E; Zhang, Yuqing; Zhou, Qi; Schünemann, Holger; Guyatt, Gordon H.
Afiliação
  • Alonso-Coello P; Clinical Epidemiology and Public Health Department, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), C/ Sant Antoni Maria Claret, 167, Pavelló 18, planta 0, 08025 Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERES
  • Carrasco-Labra A; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Evidence-Based Dentistry Unit, Faculty of Dentistry, Universidad de Chile, Sergio Livingstone 943, Santiago, Chile.
  • Brignardello-Petersen R; Evidence-Based Dentistry Unit, Faculty of Dentistry, Universidad de Chile, Sergio Livingstone 943, Santiago, Chile; Institute of Health Policy, Management & Evaluation, University of Toronto, 4th Floor, 155 College St, Toronto, Ontario M5T 3M6, Canada.
  • Neumann I; Department of Medicine, Pontificia Universidad Católica de Chile, Avenida Libertador Bernardo O Higgins 340, Santiago, Región Metropolitana, Chile.
  • Akl EA; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box: 11-0236, Riad-El-Solh, Beirut 1107 2020.
  • Vernooij RW; Clinical Epidemiology and Public Health Department, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), C/ Sant Antoni Maria Claret, 167, Pavelló 18, planta 0, 08025 Barcelona, Spain.
  • Johnston BC; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Institute of Health Policy, Management & Evaluation, University of Toronto, 4th Floor, 155 College St, Toronto, Ontario M5T 3M6, Canada; Department of Anesthesi
  • Sun X; Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu 610041, China.
  • Briel M; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, Spitalstrasse 12, 4031 Basel, Switzerland.
  • Busse JW; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Department of Anesthesia, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Michael G. DeGroote Institute for Pain Research and Care, M
  • Ebrahim S; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Meta-Research Innovation Center at Stanford (METRICS), Stanford University, 1265 Welch Road, Stanford, CA 94305, USA.
  • Granados CE; Área de investigaciones, Facultad de Medicina, Universidad de La Sabana, Campus del Puente del Común Km, 7 Autopista Norte, Chía, Colombia.
  • Iorio A; Department of Medicine, McMaster University, 1280 Main St W, Hamilton, Ontario L8S 4L8, Canada.
  • Irfan A; Department of Cardiology, University of Louisville, Rudd Heart & Lung Building, 201 Abraham Flexner Way, Suite 600, Louisville, KY 40292, USA.
  • Martínez García L; Clinical Epidemiology and Public Health Department, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), C/ Sant Antoni Maria Claret, 167, Pavelló 18, planta 0, 08025 Barcelona, Spain.
  • Mustafa RA; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Departments of Medicine and Biomedical & Health Informatics, University of Missouri-Kansas City, School of Medicine, M4-303, 2411 Holmes St, Kansas City, MO, US
  • Ramírez-Morera A; CCSS Permanent Medical Advisor, Health Care Development Division, IHCAI Foundation & Central America Cochrane, 1st Ave., 35th and 37th St, Number 3530, Barrio Escalante, San José, Costa Rica.
  • Selva A; Clinical Epidemiology and Public Health Department, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), C/ Sant Antoni Maria Claret, 167, Pavelló 18, planta 0, 08025 Barcelona, Spain.
  • Solà I; Clinical Epidemiology and Public Health Department, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), C/ Sant Antoni Maria Claret, 167, Pavelló 18, planta 0, 08025 Barcelona, Spain.
  • Sanabria AJ; Clinical Epidemiology and Public Health Department, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), C/ Sant Antoni Maria Claret, 167, Pavelló 18, planta 0, 08025 Barcelona, Spain.
  • Tikkinen KA; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Departments of Urology and Public Health, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4, 00029 Helsinki, Finland.
  • Vandvik PO; Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1130 Blindern, 0318 Oslo, Norway; Guang'anmen Hospital China Academy of Chinese Medical Science, No. 5 Bei Xian Ge St, Xuan Wu District, Beijing 100053, China.
  • Zazueta OE; Clinical Epidemiology and Public Health Department, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), C/ Sant Antoni Maria Claret, 167, Pavelló 18, planta 0, 08025 Barcelona, Spain.
  • Zhang Y; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Guang'anmen Hospital China Academy of Chinese Medical Science, No. 5 Bei Xian Ge St, Xuan Wu District, Beijing 100053, China.
  • Zhou Q; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada.
  • Schünemann H; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Department of Medicine, McMaster University, 1280 Main St W, Hamilton, Ontario L8S 4L8, Canada.
  • Guyatt GH; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Department of Medicine, McMaster University, 1280 Main St W, Hamilton, Ontario L8S 4L8, Canada.
J Clin Epidemiol ; 72: 16-26, 2016 Apr.
Article em En | MEDLINE | ID: mdl-26560992
ABSTRACT

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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Controle de Qualidade / Relatório de Pesquisa / Avaliação de Resultados da Assistência ao Paciente Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2016 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Controle de Qualidade / Relatório de Pesquisa / Avaliação de Resultados da Assistência ao Paciente Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2016 Tipo de documento: Article