Systematic reviews experience major limitations in reporting absolute effects
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Data
2016-04-01Autore
Alonso-Coello, PabloCarrasco-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
Vandvik, Per Olav
Zazueta, Oscar E.
Zhang, Yuqing
Zhou, Qi
Schünemann, Holger
Guyatt, Gordon H.
Autore/i aziendale
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Radiología e Imágenes Diagnósticas
Tipo
Artículo de revista
ISSN
0895-4356 / 1878-5921 (Electrónico)
Pagine
16-26
Tipo di oggetto
Artículo de revisión
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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.
Keywords: Absolute effect estimates; Absolute measures; Decision making; Framing; Reporting; Risk difference; Systematic review.
Keywords
Absolute measuresAbsolute effect estimates
Systematic review
Reporting
Framing
Risk difference
Decision making
Editoriale
Journal of Clinical Epidemiology; Vol. 72 (2016)
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