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    Cherry-picking by trialists and meta-analysts can drive conclusions about intervention efficacy

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    Doshi_InterventionEfficacy_2017.htm
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    Author
    Doshi, Peter
    Date
    2017-08-22
    Publisher
    Elsevier
    Type
    Article
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    Abstract
    Objective: To determine whether disagreements among multiple data sources affect systematic reviews of randomized clinical trials (RCTs). Study Design and Setting: Eligible RCTs examined gabapentin for neuropathic pain and quetiapine for bipolar depression, reported in public (e.g., journal articles) and non-public sources (clinical study reports [CSRs] and individual participant data [IPD]). Results: We found 21 gabapentin RCTs (74 reports, six IPD) and seven quetiapine RCTs (50 reports, one IPD); most were reported in journal articles (18/21 [86%] and 6/7 [86%], respectively). When available, CSRs contained the most trial design and risk of bias information. CSRs and IPD contained the most results. For the outcome domains “pain intensity” (gabapentin) and “depression” (quetiapine), we found single trials with 68 and 98 different meta-analyzable results, respectively; by purposefully selecting one meta-analyzable result for each RCT, we could change the overall result for pain intensity from effective (standardized mean difference [SMD]=-0.45; 95%CI -0.63 to -0.27) to ineffective (SMD=-0.06; 95%CI -0.24 to 0.12). We could change the effect for depression from a medium effect (SMD=-0.55; 95%CI -0.85 to -0.25) to a small effect (SMD=-0.26; 95%CI -0.41 to -0.1). Conclusions: Disagreements across data sources affect the effect size, statistical significance, and interpretation of trials and meta-analyses.
    Citation
    Mayo-Wilson, E., Li, T., Fusco, N., Bertizzolo, L., Canner, J.K., Cowley, T., Doshi, P., Ehmsen, J., Gresham, G., Guo, N., Haythornthwaite, J.A., Heyward, J., Hong, H., Pham, D., Payne, J.L., Rosman, L., Stuart, E.A., Suarez-Cuervo, C., Tolbert, E., Twose, C., Vedula, S., Dickersin, K. (2017). Cherry-Picking by Trialists and Meta-Analysts Can Drive Conclusions About Intervention Efficacy. Journal of Clinical Epidemiology. DOI: 10.1016/j.jclinepi.2017.07.014
    Keyword
    clinical study reports
    data comparison
    publication bias
    reporting bias
    Systematic reviews (Medical research)
    Data Accuracy
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/7090
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jclinepi.2017.07.014
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