Assessment of early exaggerated treatment effects in orthodontic interventions using cumulative meta-analysis.
Journal
European journal of orthodontics
ISSN: 1460-2210
Titre abrégé: Eur J Orthod
Pays: England
ID NLM: 7909010
Informations de publication
Date de publication:
04 10 2021
04 10 2021
Historique:
pubmed:
30
6
2021
medline:
28
10
2021
entrez:
29
6
2021
Statut:
ppublish
Résumé
The reported initial strong treatment effects reported in early trials that are refuted in subsequent future studies assessing the same interventions have been attributed to novelty bias. The aim of this study was to determine whether there is any evidence of novelty bias in the reported treatment effects of orthodontics interventions. Relevant orthodontic systematic review (SRs) topics containing at least one meta-analysis on either binary or continuous outcomes with a minimum of three trials considered important areas in the field of orthodontic practice were identified. SR, meta-analysis, and primary study-level characteristics were extracted. Descriptive statistics were calculated at the SRs, meta-analysis, and at the individual study level. All SR and trial-level data were imported into the statistical software and all meta-analyses were replicated using the cumulative random-effects meta-analysis approach. Changes in the size and direction of the estimates between the first trial and the cumulative effect over time were recorded. Forty-seven meta-analyses were included. The total number of primary studies included within these meta-analyses was 408 (N = 408). Overall, the final effect size estimate decreased in 29 (61.7%, N = 29/47) cumulative meta-analyses whilst it increased in the remaining 18 (38.3%, N = 18/47). No association between the level of risk of bias and the cumulative absolute effect size was evident (OR 1.00; 95% CI: 0.98, 1.03; P = 0.717) after adjusting for year of the primary study (P = 0.22). Clinicians should be wary of the results of trials reporting the effectiveness of new interventions as there is a possibility that the reported effect size will be often exaggerated.
Sections du résumé
BACKGROUND
The reported initial strong treatment effects reported in early trials that are refuted in subsequent future studies assessing the same interventions have been attributed to novelty bias. The aim of this study was to determine whether there is any evidence of novelty bias in the reported treatment effects of orthodontics interventions.
MATERIALS AND METHODS
Relevant orthodontic systematic review (SRs) topics containing at least one meta-analysis on either binary or continuous outcomes with a minimum of three trials considered important areas in the field of orthodontic practice were identified. SR, meta-analysis, and primary study-level characteristics were extracted. Descriptive statistics were calculated at the SRs, meta-analysis, and at the individual study level. All SR and trial-level data were imported into the statistical software and all meta-analyses were replicated using the cumulative random-effects meta-analysis approach. Changes in the size and direction of the estimates between the first trial and the cumulative effect over time were recorded.
RESULTS
Forty-seven meta-analyses were included. The total number of primary studies included within these meta-analyses was 408 (N = 408). Overall, the final effect size estimate decreased in 29 (61.7%, N = 29/47) cumulative meta-analyses whilst it increased in the remaining 18 (38.3%, N = 18/47). No association between the level of risk of bias and the cumulative absolute effect size was evident (OR 1.00; 95% CI: 0.98, 1.03; P = 0.717) after adjusting for year of the primary study (P = 0.22).
CONCLUSIONS
Clinicians should be wary of the results of trials reporting the effectiveness of new interventions as there is a possibility that the reported effect size will be often exaggerated.
Identifiants
pubmed: 34184029
pii: 6310963
doi: 10.1093/ejo/cjab042
pmc: PMC8633600
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
601-605Subventions
Organisme : Department of Health
Pays : United Kingdom
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Références
BMC Med Res Methodol. 2013 Mar 25;13:50
pubmed: 23530582
JAMA. 1996 Oct 23-30;276(16):1332-8
pubmed: 8861993
Lancet. 1998 Jan 10;351(9096):123-7
pubmed: 9439507
J Orthod. 2019 Jun;46(1_suppl):9-12
pubmed: 31056035
Epidemiology. 2008 Sep;19(5):640-8
pubmed: 18633328
J Clin Psychopharmacol. 2004 Apr;24(2):126-30
pubmed: 15206658
Lancet. 2018 Apr 7;391(10128):1357-1366
pubmed: 29477251
N Engl J Med. 1992 Jul 23;327(4):248-54
pubmed: 1614465
Open Dent J. 2010;4:92-123
pubmed: 21673839
J Clin Epidemiol. 2021 May;133:14-23
pubmed: 33359320
N Engl J Med. 1997 Aug 21;337(8):536-42
pubmed: 9262498
Am J Epidemiol. 2018 May 1;187(5):1113-1122
pubmed: 29126260
Stat Med. 2010 Oct 15;29(23):2369-83
pubmed: 20687172
JAMA. 2007 Dec 5;298(21):2517-26
pubmed: 18056905
Science. 2015 Aug 28;349(6251):aac4716
pubmed: 26315443
Sci Am. 2011 Jun;304(6):16
pubmed: 21608392
Lancet. 2014 Jan 11;383(9912):156-65
pubmed: 24411644
JAMA. 2005 Jul 13;294(2):218-28
pubmed: 16014596
J Dent. 2015 Apr;43(4):397-404
pubmed: 25676182
PLoS One. 2014 Jul 28;9(7):e102670
pubmed: 25068257
Lancet. 2010 Jul 3;376(9734):20-1
pubmed: 20609983
BMJ. 2019 Aug 28;366:l4898
pubmed: 31462531
Clin Trials. 2017 Oct;14(5):483-488
pubmed: 28670909
BMC Med Res Methodol. 2006 May 11;6:25
pubmed: 16689990