Reporting, handling and assessing the risk of bias associated with missing participant data in systematic reviews : a methodological survey
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Date
2015Les auteurs
Akl, Elie A.Carrasco-Labra, Alonso
Brignardello-Petersen, Romina
Neumann, Ignacio
Johnston, Bradley 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 O.
Vernooij, Robin W. M.
Zazueta, Oscar E.
Qi, Zhou
Guyatt, Gordon H.
Alonso-Coello, Pablo
Auteur(s) d'entreprise
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Radiología e Imágenes Diagnósticas
Type
Artículo de revista
ISSN
2044-6055 (Electrónico)
Des pages
1-8
Type d'élément
Artículo de investigación
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Abstrait
Objectives To describe how systematic reviewers are reporting missing data for dichotomous outcomes, handling them in the analysis and assessing the risk of associated bias.
Methods We searched MEDLINE and the Cochrane Database of Systematic Reviews for systematic reviews of randomised trials published in 2010, and reporting a meta-analysis of a dichotomous outcome. We randomly selected 98 Cochrane and 104 non-Cochrane systematic reviews. Teams of 2 reviewers selected eligible studies and abstracted data independently and in duplicate using standardised, piloted forms with accompanying instructions. We conducted regression analyses to explore factors associated with using complete case analysis and with judging the risk of bias associated with missing participant data.
Results Of Cochrane and non-Cochrane reviews, 47% and 7% (p<0.0001), respectively, reported on the number of participants with missing data, and 41% and 9% reported a plan for handling missing categorical data. The 2 most reported approaches for handling missing data were complete case analysis (8.5%, out of the 202 reviews) and assuming no participants with missing data had the event (4%). The use of complete case analysis was associated only with Cochrane reviews (relative to non-Cochrane: OR=7.25; 95% CI 1.58 to 33.3, p=0.01). 65% of reviews assessed risk of bias associated with missing data; this was associated with Cochrane reviews (relative to non-Cochrane: OR=6.63; 95% CI 2.50 to 17.57, p=0.0001), and the use of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology (OR=5.02; 95% CI 1.02 to 24.75, p=0.047).
Conclusions Though Cochrane reviews are somewhat less problematic, most Cochrane and non-Cochrane systematic reviews fail to adequately report and handle missing data, potentially resulting in misleading judgements regarding risk of bias.
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
Lien vers la ressource
https://bmjopen.bmj.com/content/5/9/e009368Origine
BMJ Open; Vol. 5 Núm. 9 (2015)
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