Completeness of main outcomes across randomized trials in entire discipline: survey of chronic lung disease outcomes in preterm infants

Ioannidis, John P. A.; Horbar, Jeffrey D.; Ovelman, Colleen; Brosseau, Yolanda; Thorlund, Kristian; Buus‐Frank, Madge E.; Mills, Edward J.; Soll, Roger F.

doi:10.1136/bmj.h72

Cited by 25 publications

(15 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The first reason is ethical: volunteers who participate in human experiments (trials) expect their contributions to increase knowledge and improve clinical care [4]. Clinical care is increasingly based on distilled trial evidence available in reviews.…”

Section: Introductionmentioning

confidence: 99%

Clinical trials and systematic reviews addressing similar interventions for the same condition do not consider similar outcomes to be important: a case study in HIV/AIDS

Saldanha

Yang

et al. 2017

Journal of Clinical Epidemiology

View full text Add to dashboard Cite

BACKGROUND The usefulness of clinical trials and systematic reviews is compromised when they report different outcomes. We compared outcomes in reviews of HIV/AIDS and the trials included in the reviews. STUDY DESIGN AND SETTING We examined all Cochrane reviews of HIV/AIDS (as of June 2013) that included ≥ 1 trial, and the trials that the reviews included. We compared outcomes within subgroups defined by type of intervention: clinical management, biomedical prevention, behavioral prevention, and health services. RESULTS We included 84 reviews that encompassed 524 trials. Although the median number of outcomes per trial (8) and per review (7.5) was similar, the trials reported a considerably greater number of unique outcomes than the reviews (779 vs. 218), ranging from 2.3 times greater (clinical management) to 5.4 times greater (behavioral prevention). High proportions of trial outcomes were not in any review: 68% (clinical management) to 83% (behavioral prevention). Lower proportions of review outcomes were not in any trial: 11% (clinical management) to 39% (health services). CONCLUSION Outcomes in trials and reviews are not well aligned for appropriate inclusion of trial results in reviews and meta-analyses. Differences in perspectives, goals, and constraints between trialists and reviewers may explain differences in outcomes they consider important.

show abstract

Section: Introductionmentioning

confidence: 99%

Clinical trials and systematic reviews addressing similar interventions for the same condition do not consider similar outcomes to be important: a case study in HIV/AIDS

Saldanha

Yang

et al. 2017

Journal of Clinical Epidemiology

View full text Add to dashboard Cite

show abstract

“…Further, reviews of intervention effectiveness pre-specify outcomes and indicate where these outcomes are missing from trial reports. [3, 39, 40] For example, choice of outcomes in a trial may be related to what data can be gathered easily (i.e., interim outcomes), and may not always address questions that need to be answered. An example is the focus of glaucoma trials on intraocular pressure instead of visual field, the patient-important outcome that influences visual functioning.…”

Section: Discussionmentioning

confidence: 99%

“…Reviews sometimes miss important outcomes reported in trials. [40] Therefore, the number of outcomes examined in trials included in the reviews we examined might be greater than the number of outcomes examined in the reviews. Although Cochrane recommends that systematic reviewers select outcomes without considering trial outcomes,[34] future research should compare the central outcomes of networks developed using the two starting points (trials and reviews).…”

Section: Discussionmentioning

confidence: 99%

Social network analysis identified central outcomes for core outcome sets using systematic reviews of HIV/AIDS

Saldanha

Yang

et al. 2016

Journal of Clinical Epidemiology

View full text Add to dashboard Cite

Objective Methods to develop core outcome sets, the minimum outcomes that should be measured in research in a topic area, vary. We applied social network analysis methods to understand outcome co-occurrence patterns in HIV/AIDS systematic reviews, and identify outcomes central to the network of outcomes in HIV/AIDS. Study Design and Setting We examined all Cochrane reviews of HIV/AIDS as of June 2013. We defined a tie as two outcomes (nodes) co-occurring in ≥2 reviews. To identify central outcomes, we used normalized node betweenness centrality (nNBC) (the extent to which connections between other outcomes in a network rely on that outcome as an intermediary). We conducted a subgroup analysis by HIV/AIDS intervention type (i.e., clinical management, biomedical prevention, behavioral prevention, and health services). Results The 140 included reviews examined 1140 outcomes, 294 of which were unique. The most central outcome overall was all-cause mortality (nNBC=23.9). The most central and most frequent outcomes differed overall and within subgroups. For example, ‘adverse events (specified)’ was among the most central but not among the most frequent outcomes, overall. Conclusion Social network analysis methods are a novel application to identify central outcomes, which provides additional information potentially useful for developing core outcome sets.

show abstract

“…Additionally, 'systematic reviews of outcome measures' have exposed inconsistencies in: outcome selection and timing of assessment in mechanical ventilation trials for measuring duration of ventilation [14 & ]; instruments and clinimetric properties of outcomes measuring functional impairment and limitations in the critically ill [15]; and a lack of data on an important patient-relevant outcome (chronic lung disease) in trials included in systematic reviews of critically ill neonates [16]. These reviews highlight the need to ensure that critical care trial investigators measure outcomes that are the most important ones for patients and conditions examined; and that the right measure is used at the most appropriate time-point.…”

Section: Disorder In Selecting and Measuring Critical Care Outcomesmentioning

confidence: 99%

Progress on core outcome sets for critical care research

Blackwood¹,

Marshall

Rose

2015

Current Opinion in Critical Care

View full text Add to dashboard Cite

Development and utilization of core outcome sets for studies relevant to the critically ill is in its infancy compared to other specialties. Notwithstanding, core outcome set development frameworks and guidelines are available, several sets are in various stages of development, and there is strong support from international investigator-led collaborations including the International Forum for Acute Care Trialists.

show abstract

Completeness of main outcomes across randomized trials in entire discipline: survey of chronic lung disease outcomes in preterm infants

Cited by 25 publications

References 26 publications

Clinical trials and systematic reviews addressing similar interventions for the same condition do not consider similar outcomes to be important: a case study in HIV/AIDS

Clinical trials and systematic reviews addressing similar interventions for the same condition do not consider similar outcomes to be important: a case study in HIV/AIDS

Social network analysis identified central outcomes for core outcome sets using systematic reviews of HIV/AIDS

Progress on core outcome sets for critical care research

Contact Info

Product

Resources

About