Systematic Review Reveals Lack of Causal Methodology Applied to Pooled Longitudinal Observational Infectious Disease Studies

Hufstedler, Heather; Rahman, Sabahat; Danzer, Alexander M.; Goymann, Hannah; Jong, Valentijn M. T. de; Campbell, Harry F.; Gustafson, Paul; Debray, Thomas P A; Jaenisch, Thomas; Maxwell, Lauren; Matthay, Ellicott C.; Bärnighausen, Till

doi:10.1016/j.jclinepi.2022.01.008

Cited by 3 publications

(7 citation statements)

References 60 publications

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“…Although all included IPD-MAs were considered to have causal intent, all but three used standard RBA analyses. This nding is consistent with other reviews suggesting underutilization of causal methods in medicine or medical sub elds (21,23,64). This may be due to the high variability in data elements and study designs, which can pose challenges in applying certain methods for pooled data as compared to analyzing a single dataset.…”

Section: Causal Methodssupporting

confidence: 92%

“…The search strategy for this systematic review was developed by four researchers (HH, LM, EM, SR) and was reviewed and edited by information scientists from University Hospital Heidelberg (UKHD), University of California San Francisco (UCSF), and Harvard University. Similar to a previous review on infectious diseases (23), we chose not to include names of methods we considered "causal" but instead, allowed for methods not considered "causal", such as standard RBAs, to be reviewed to prevent bias in the results. The search strategy was tailored to four large platforms so as to include non-medical disciplines (EBSCO [PsycINFO, Academic Search Complete, Business Source Premier, CINAHL, EconLit], EMBASE, PubMed and Web of Science).…”

Section: Search Strategymentioning

confidence: 99%

“…The search strategy yielded 16,443 unique articles. Of the 210 articles which were eligible at the initial title-abstract phase, seven duplicates and 31 articles with e-publication dates other than eligible years were excluded, as well as the ve non-medical articles (explained in sections 2.2 Study Selection process), resulting in 167 eligible medical articles for full-text review (2009, n = 23; 2014, n = 44; 2019, n = 100), general medicine (32), neoplasms (24), vascular disease (23), internal medicine (15), public health (15), nutritional sciences (9), neurology (7), endocrinology (7), surgery, other specialty (6), environmental health (5), psychiatry (5), communicable diseases (4), drugs therapy (2), genetics (2), geriatrics (2), pregnancy (2), therapeutics (2), allergy and immunology (1), complementary therapies (1), critical care (1), dentistry (1), and metabolism (1). See Supplementary Material C. Full Article List to see the breakdown by year and sampled studies.…”

Section: Study Selectionmentioning

confidence: 99%

“…Several reviews have shown that causal methods, which employ statistical techniques beyond abovementioned standard RBA analyses, are implemented in single observational studies in medicine (21,22). However, a recent review (23) revealed that causal methods are rarely applied to IPD-MAs with infectious disease data. The objective of this systematic review is to expand on the previous review (23), and investigate the rigor in the implementation and reporting of causal methods in pooled longitudinal IPD studies in medicine.…”

Section: Introductionmentioning

confidence: 99%

“…However, a recent review (23) revealed that causal methods are rarely applied to IPD-MAs with infectious disease data. The objective of this systematic review is to expand on the previous review (23), and investigate the rigor in the implementation and reporting of causal methods in pooled longitudinal IPD studies in medicine.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Application of Causal Inference Methods to Pooled Longitudinal Non- Randomized Studies: A Methodological Systematic Review

Hufstedler,

Mauer,

Yeboah

et al. 2023

Preprint

Self Cite

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Observational data provide invaluable real-world information in medicine, but certain methodological considerations are required to derive causal estimates. In this systematic review, we evaluated the methodology and reporting quality of individual-level patient data meta-analyses (IPD-MAs) published in 2009, 2014, and 2019 that sought to estimate a causal relationship in medicine. We screened over 16,000 titles and abstracts, reviewed 45 full-text articles out of the 167 deemed potentially eligible, and included 29 into the analysis. Unfortunately, we found that causal methodologies were rarely implemented, and reporting was generally poor across studies. Specifically, only three of the 29 articles used quasi-experimental methods, and no study used G-methods to adjust for time-varying confounding. To address these issues, we propose stronger collaborations between physicians and methodologists to ensure that causal methodologies are properly implemented in IPD-MAs. In addition, we put forward a suggested checklist of reporting guidelines for IPD-MAs that utilize causal methods. This checklist could improve reporting thereby potentially enhancing the quality and trustworthiness of IPD-MAs, which can be considered one of the most valuable sources of evidence for health policy.

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Section: Causal Methodssupporting

confidence: 92%

Section: Search Strategymentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Application of Causal Inference Methods to Pooled Longitudinal Non- Randomized Studies: A Methodological Systematic Review

Hufstedler,

Mauer,

Yeboah

et al. 2023

Preprint

Self Cite

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Application of causal inference methods in individual-participant data meta-analyses in medicine: addressing data handling and reporting gaps with new proposed reporting guidelines

Hufstedler,

Mauer,

Yeboah

et al. 2024

BMC Med Res Methodol

View full text Add to dashboard Cite

Observational data provide invaluable real-world information in medicine, but certain methodological considerations are required to derive causal estimates. In this systematic review, we evaluated the methodology and reporting quality of individual-level patient data meta-analyses (IPD-MAs) conducted with non-randomized exposures, published in 2009, 2014, and 2019 that sought to estimate a causal relationship in medicine. We screened over 16,000 titles and abstracts, reviewed 45 full-text articles out of the 167 deemed potentially eligible, and included 29 into the analysis. Unfortunately, we found that causal methodologies were rarely implemented, and reporting was generally poor across studies. Specifically, only three of the 29 articles used quasi-experimental methods, and no study used G-methods to adjust for time-varying confounding. To address these issues, we propose stronger collaborations between physicians and methodologists to ensure that causal methodologies are properly implemented in IPD-MAs. In addition, we put forward a suggested checklist of reporting guidelines for IPD-MAs that utilize causal methods. This checklist could improve reporting thereby potentially enhancing the quality and trustworthiness of IPD-MAs, which can be considered one of the most valuable sources of evidence for health policy.

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COVID-19 Lockdown in Israel: The Environmental Effect on Ultrafine Particle Content in the Airway

Klein

Elimeleh

Adir

et al. 2022

IJERPH

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Inhaled ultrafine particle (UFP) content in exhaled breath condensate (EBC) was observed as an airway inflammatory marker and an indicator of exposure to particulate matter (PM). The exceptional decline in air pollution during the COVID-19 lockdown was an opportunity to evaluate the effect of environmental changes on UFP airway content. We collected EBC samples from 30 healthy subjects during the first lockdown due to COVID-19 in Israel (March–April 2020) and compared them to EBC samples retrieved during April–June 2016 from 25 other healthy subjects (controls) living in the same northern Israeli district. All participants underwent EBC collection and blood sampling. Ambient air pollutant levels were collected from the Israeli Ministry of Environmental Protection’s online database. Data were acquired from the monitoring station closest to each subject’s home address, and means were calculated for a duration of 1 month preceding EBC collection. UFP contents were measured in the EBC and blood samples by means of the NanoSight LM20 system. There was a dramatic reduction in NO, NO2, SO2, and O3 levels during lockdown compared to a similar period in 2016 (by 61%, 26%, 50%, and 45%, respectively). The specific NO2 levels were 8.3 ppb for the lockdown group and 11.2 ppb for the controls (p = 0.01). The lockdown group had higher UFP concentrations in EBC and lower UFP concentrations in serum compared to controls (0.58 × 108/mL and 4.3 × 108/mL vs. 0.43 × 108/mL and 6.7 × 108/mL, p = 0.05 and p = 0.03, respectively). In this observational study, reduced levels of air pollution during the COVID-19 lockdown were reflected in increased levels of UFP airway contents. The suggested mechanism is that low airway inflammation levels during lockdown resulted in a decreased UFP translocation to serum. Further studies are needed to confirm this hypothesis.

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Systematic Review Reveals Lack of Causal Methodology Applied to Pooled Longitudinal Observational Infectious Disease Studies

Cited by 3 publications

References 60 publications

Application of Causal Inference Methods to Pooled Longitudinal Non- Randomized Studies: A Methodological Systematic Review

Application of Causal Inference Methods to Pooled Longitudinal Non- Randomized Studies: A Methodological Systematic Review

Application of causal inference methods in individual-participant data meta-analyses in medicine: addressing data handling and reporting gaps with new proposed reporting guidelines

COVID-19 Lockdown in Israel: The Environmental Effect on Ultrafine Particle Content in the Airway

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