Small study effects in meta-analyses of osteoarthritis trials: meta-epidemiological study.

BMJ : British Medical Journal
Eveline NüeschPeter Jüni

Abstract

To examine the presence and extent of small study effects in clinical osteoarthritis research. Meta-epidemiological study. 13 meta-analyses including 153 randomised trials (41 605 patients) that compared therapeutic interventions with placebo or non-intervention control in patients with osteoarthritis of the hip or knee and used patients' reported pain as an outcome. We compared estimated benefits of treatment between large trials (at least 100 patients per arm) and small trials, explored funnel plots supplemented with lines of predicted effects and contours of significance, and used three approaches to estimate treatment effects: meta-analyses including all trials irrespective of sample size, meta-analyses restricted to large trials, and treatment effects predicted for large trials. On average, treatment effects were more beneficial in small than in large trials (difference in effect sizes -0.21, 95% confidence interval -0.34 to -0.08, P=0.001). Depending on criteria used, six to eight funnel plots indicated small study effects. In six of 13 meta-analyses, the overall pooled estimate suggested a clinically relevant, significant benefit of treatment, whereas analyses restricted to large trials and predicted effects in large tri...Continue Reading

References

Sep 1, 1986·Controlled Clinical Trials·R DerSimonian, N Laird
Feb 1, 1995·JAMA : the Journal of the American Medical Association·K F SchulzD G Altman
Oct 6, 1997·BMJ : British Medical Journal·M EggerC Minder
Feb 6, 1998·BMJ : British Medical Journal·M Egger, G D Smith
Mar 11, 1998·BMJ : British Medical Journal·L IrwigP Glasziou
Sep 18, 1999·Osteoarthritis and Cartilage·E Eberle, B Ottillinger
Oct 16, 1999·Statistics in Medicine·S G Thompson, S J Sharp
Jul 7, 2001·BMJ : British Medical Journal·P JüniM Egger
Sep 29, 2001·Journal of Clinical Epidemiology·J A Sterne, M Egger
Jun 1, 2002·JAMA : the Journal of the American Medical Association·Karin Huwiler-MüntenerMatthias Egger
Aug 15, 2003·The Cochrane Database of Systematic Reviews·M FransenM Bell
Dec 18, 2003·JAMA : the Journal of the American Medical Association·Grace H LoDavid T Felson
May 27, 2004·JAMA : the Journal of the American Medical Association·An-Wen ChanDouglas G Altman
Apr 23, 2005·The Cochrane Database of Systematic Reviews·T E TowheedG Wells
Sep 21, 2005·Annals of Internal Medicine·Joshua ChodoshPaul Shekelle
Dec 14, 2005·Statistics in Medicine·Roger M HarbordJonathan A C Sterne
Jan 27, 2006·The Cochrane Database of Systematic Reviews·T E TowheedG Wells
Sep 19, 2006·Best Practice & Research. Clinical Rheumatology·Peter JüniPaul Dieppe
Sep 27, 2006·Archives of Internal Medicine·Bernhard RintelenBurkhard F Leeb
Apr 18, 2007·Annals of Internal Medicine·Stephan ReichenbachPeter Jüni
Apr 20, 2007·The Cochrane Database of Systematic Reviews·S HopewellM Egger
May 23, 2007·International Journal of Epidemiology·J PildalP C Gøtzsche
Jun 20, 2007·Annals of Internal Medicine·Eric ManheimerBrian M Berman
Jun 30, 2007·Arthritis and Rheumatism·Steven C VladDavid T Felson
Oct 19, 2007·The Cochrane Database of Systematic Reviews·E M BartelsB Danneskiold-Samsøe
Oct 19, 2007·The Cochrane Database of Systematic Reviews·A P VerhagenH C W de Vet
Jan 18, 2008·The New England Journal of Medicine·Erick H TurnerRobert Rosenthal
Jun 10, 2008·Journal of Clinical Epidemiology·Jaime L PetersLesley Rushton
Dec 17, 2008·International Journal of Epidemiology·Eveline Nüesch, Peter Jüni
Jan 14, 2009·BMC Medical Research Methodology·Santiago G MorenoNicola J Cooper
Jan 23, 2009·The Cochrane Database of Systematic Reviews·Sally HopewellKay Dickersin
Aug 15, 2009·BMJ : British Medical Journal·Britta TendalPeter C Gøtzsche
Oct 13, 2009·The Cochrane Database of Systematic Reviews·Anne Ws RutjesPeter Jüni

❮ Previous
Next ❯

Citations

Jun 26, 2013·British Journal of Anaesthesia·R A MooreP J Wiffen
Jul 3, 2013·International Journal of Epidemiology·Anna ChaimaniGeorgia Salanti
Feb 28, 2013·Rheumatology·Kun Zou, Weiya Zhang
Apr 26, 2013·BMJ : British Medical Journal·Agnes DechartresPhilippe Ravaud
Jan 7, 2011·BMC Neurology·Pawin NumthavajJohn Attia
Jan 11, 2013·Critical Care : the Official Journal of the Critical Care Forum·Zhongheng ZhangHongying Ni
Dec 24, 2013·PloS One·Michal Kicinski
Oct 22, 2013·Acupuncture in Medicine : Journal of the British Medical Acupuncture Society·Stephanie L PradyHugh MacPherson
Sep 6, 2014·Psychological Medicine·H GergerJ Barth
Nov 3, 2010·Nature Reviews. Rheumatology·Axel Finckh, Martin R Tramèr
Oct 7, 2011·European Journal of Anaesthesiology·Robert Andrew MooreDominic Aldington
Dec 10, 2015·Drugs & Aging·Féline P B KroonMargreet Kloppenburg
Apr 15, 2014·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Marcel RuzickaSwapnil Hiremath
Jan 21, 2014·Lancet·Swapnil Hiremath, Ayub Akbari
Jan 28, 2016·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Victoria J MaddenTasha R Stanton
Oct 27, 2015·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·M NazarzadehA Sanjari Moghaddam
Feb 7, 2012·Complementary Therapies in Medicine·Seo Ryang WeByung-Il Min
May 3, 2011·Journal of Clinical Epidemiology·Santiago G MorenoKeith R Abrams
Sep 15, 2015·Seminars in Fetal & Neonatal Medicine·Ian P Sinha, Sunil K Sinha
Jan 30, 2016·Expert Review of Gastroenterology & Hepatology·Piet J LodewijkxUNKNOWN Dutch Pancreatitis Study Group
Jun 5, 2013·European Journal of Pain : EJP·R A MooreT R Tölle
Aug 27, 2014·International Journal of Cancer. Journal International Du Cancer·NaNa KeumEdward L Giovannucci
Nov 17, 2015·Evidence-based Complementary and Alternative Medicine : ECAM·Xian-Liang LiuYan Shi
Mar 29, 2016·Plastic and Reconstructive Surgery·Sumanas W JordanJohn Y S Kim
Nov 19, 2014·Journal of Orthodontics·Spyridon N Papageorgiou

❮ Previous
Next ❯

Software Mentioned

Stata

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.