What contributions do languages other than English make on the results of meta-analyses?

Moher, David; Pham,; Klassen, Terry P; Schulz, Kenneth F.; Berlin, Jesse A.; Jadad, Alejandro R.; Liberati, Alessandro

doi:10.1016/s0895-4356(00)00188-8

Cited by 402 publications

(274 citation statements)

References 27 publications

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“…We excluded non-English studies because language-restricted meta-analysis does not induce any bias in the estimates of intervention effectiveness. 86 We established a stringent minimum sample size in the design of meta-analysis to avoid nonrobust conclusions. However, we are aware that the possibility of a degree of "file drawer effect" or publication bias cannot be ruled out in a study with 7 small RCTs including 545 patients.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival

2003

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There is no standard treatment for patients with unresectable hepatocellular carcinoma (HCC). Survival benefits derived from medical interventions are controversial. The aim of this systematic review was to assess the evidence of the impact of medical treatments on survival. Randomized controlled trials (RCTs) that were published as full papers assessing survival for primary treatments of HCC were included. MEDLINE, the Cochrane Library, CANCERLIT, and a manual search from 1978 to May 2002 were used. The primary end point was survival, and the secondary end point was response to treatment. Estimates of effect were calculated according to the random effects model. Sensitivity analysis included methodological quality. We identified 61 randomized trials, but only 14 met the criteria to perform a meta-analysis assessing arterial embolization (7 trials, 545 patients) or tamoxifen T he incidence of hepatocellular carcinoma (HCC) is increasing worldwide. 1 Liver cancer is the fifth most common cancer in the world and the third most common cause of cancer-related death. 2 Cohort studies and cost-efficiency modeling have suggested that surveillance of well-defined cirrhotic patients may decrease tumor-related mortality. However, only 30% of patients benefit from curative therapies such as resection, transplantation, or percutaneous ablation 3 and achieve 5-year survival rates of 50% to 75%. 4 Most patients with HCC are diagnosed at intermediate to advanced stages, and there is no standard treatment for these patients. 3,4 The most reliable method to show survival advantages is to perform large randomized controlled trials (RCTs) that include more than 1,000 patients comparing treatment versus no treatment in a well-defined strata of individuals. 5-10 These investigations are lacking in patients with HCC. On the contrary, several medical interventions have been tested in the setting of small RCTs. However, the reduced size of these studies may cause questions of their statistical power when detecting survival differences, which, as in many areas of health care and oncology, are unlikely to be large. This raises the need for a systematic meta-analysis assessment, with a major role to integrate valid information and provide estimates of treatment effects when RCTs themselves are not of sufficient size. 9,10 Two systematic reviews published years ago 11,12 suggested a potential benefit for at Abbreviations: HCC, hepatocellular carcinoma; RCT, randomized controlled trial; OR, odds ratio; CI, confidence interval.

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Section: Discussionmentioning

confidence: 99%

Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival

2003

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“…There was one non-English trial (17) that met our inclusion criteria. However, this study was not included in our review because of difficulties getting the manuscript translated and based on evidence that inclusion of non-English trials does not significantly alter results of meta-analyses (18).…”

Section: Methodsmentioning

confidence: 99%

Psychological interventions for rheumatoid arthritis: A meta‐analysis of randomized controlled trials

Astin¹,

Beckner²,

Soeken³

et al. 2002

Arthritis & Rheumatism

294

184

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Objective. To carry out a systematic review of the literature examining the efficacy of psychological interventions (e.g., relaxation, biofeedback, cognitive-behavioral therapy) in the treatment of rheumatoid arthritis (RA). Methods. Studies that met the following criteria were included: random assignment, wait-list or usual care control condition; publication in peer-reviewed journals; treatment that included some psychological component beyond simply providing education information; and separate data provided for patients with RA if subjects with conditions other than RA were included. Two investigators independently extracted data on study design, sample size and characteristics, type of intervention, type of control, direction and nature of the outcome(s). Results. Twenty-five trials met the inclusion criteria. Methodologic quality was assessed, and effect sizes were calculated for 6 outcomes. Significant pooled effect sizes were found postintervention for pain (

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“…This analysis was confined to English-language articles, which could introduce bias. However, Moher et al (17) found that language-restricted metaanalyses overestimated treatment effect by only 2% on average, compared with language-inclusive meta-analyses, although the language-inclusive metaanalyses were more precise. Publication bias is always a concern in meta-analyses, and we performed exhaustive searches and contacted investigators in the field to obtain all published studies.…”

Section: Meta-regressionmentioning

confidence: 99%

“…Searches were confined to the English language because in a recent study, effect sizes did not differ significantly in language-restricted metaanalyses compared with languageinclusive ones (17), and there is some evidence of lower quality in the nonEnglish medical literature (18). Abstracts were not included because they generally had insufficient information to assess the validity of the study by the criteria used in this meta-analysis.…”

Section: Data Sourcesmentioning

confidence: 99%

Self-Management Education for Adults With Type 2 Diabetes

Norris

Lau

Sj³

et al. 2002

Diabetes Care

1,515

1,067

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OBJECTIVE -To evaluate the efficacy of self-management education on GHb in adults with type 2 diabetes. Medline (1980), Cinahl (1982, and the Educational Resources Information Center database (ERIC) (1980 -1999), and we manually searched review articles, journals with highest topic relevance, and reference lists of included articles. Studies were included if they were randomized controlled trials that were published in the English language, tested the effect of self-management education on adults with type 2 diabetes, and reported extractable data on the effect of treatment on GHb. A total of 31 studies of 463 initially identified articles met selection criteria. We computed net change in GHb, stratified by follow-up interval, tested for trial heterogeneity, and calculated pooled effects sizes using random effects models. We examined the effect of baseline GHb, follow-up interval, and intervention characteristics on GHb. RESEARCH DESIGN AND METHODS -We searched for English language trials inRESULTS -On average, the intervention decreased GHb by 0.76% (95% CI 0.34 -1.18) more than the control group at immediate follow-up; by 0.26% (0.21% increase -0.73% decrease) at 1-3 months of follow-up; and by 0.26% (0.05-0.48) at Ն4 months of follow-up. GHb decreased more with additional contact time between participant and educator; a decrease of 1% was noted for every additional 23.6 h (13.3-105.4) of contact.CONCLUSIONS -Self-management education improves GHb levels at immediate followup, and increased contact time increases the effect. The benefit declines 1-3 months after the intervention ceases, however, suggesting that learned behaviors change over time. Further research is needed to develop interventions effective in maintaining long-term glycemic control.

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What contributions do languages other than English make on the results of meta-analyses?

Cited by 402 publications

References 27 publications

Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival

Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival

Psychological interventions for rheumatoid arthritis: A meta‐analysis of randomized controlled trials

Self-Management Education for Adults With Type 2 Diabetes

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