Journal of clinical epidemiology
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Meta Analysis Comparative Study
Adjustment for compliance behavior in trials of epidural analgesia in labor using instrumental variable meta-analysis.
Intention-to-treat (ITT) analysis of randomized controlled trials (RCTs) may cause bias when compliance is poor. Noncompliance describes failure to comply with allocation in the intervention arm, and contamination describes uptake of the intervention in the control arm. Instrumental variable (IV) analysis can be applied in addition to the primary ITT analysis to estimate the causal effect adjusted for noncompliance and contamination, assuming that noncompliers would have had the same treatment benefit as compliers. We aimed to compare ITT and IV meta-analysis of the association between epidural analgesia in labor and cesarean section. ⋯ ITT meta-analysis underestimates the effect of receiving epidural analgesia in labor on cesarean section compared with IV meta-analysis.
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Review Meta Analysis
Systematic reviews of low back pain prognosis had variable methods and results: guidance for future prognosis reviews.
Systematic reviews of prognostic factors for low back pain vary substantially in design and conduct. The objective of this study was to identify, describe, and synthesize systematic reviews of low back pain prognosis, and explore the potential impact of review methods on the conclusions. ⋯ There is an immediate need for methodological work in the area of prognosis systematic reviews. Because of methodological shortcomings in the primary and review literature, there remains uncertainty about reliability of conclusions regarding prognostic factors for low back pain.
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Review Meta Analysis
The account for provider and center effects in multicenter interventional and surgical randomized controlled trials is in need of improvement: a review.
To systematically review the account of center and provider effects in large surgical and interventional randomized controlled trials. ⋯ Only few trials account for center or provider effect in the design and analysis. Authors and journal editors could play an important role in improving the reporting of trials.
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Review Meta Analysis
A systematic review finds methodological improvements necessary for prognostic models in determining traumatic brain injury outcomes.
To describe the modeling techniques used for early prediction of outcome in traumatic brain injury (TBI) and to identify aspects for potential improvements. ⋯ Although most models agree on the three most important predictors, many were developed on small sample sizes within single centers and hence lack generalizability. Modeling strategies have to be improved, and include external validation.
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Review Meta Analysis
Methodological quality and homogeneity influenced agreement between randomized trials and nonrandomized studies of the same intervention for back pain.
To determine the influence of methodological quality and homogeneity on the agreement between pairs of randomized trials (RCTs) and nonrandomized studies (NRSs) of the same interventions for low-back problems. Homogeneity was assessed regarding settings, population, interventions, and outcomes. ⋯ Pairs of low-quality studies disagreed more than pairs where at least one study was of high quality. However, pairs with similar settings, population, interventions, and outcomes showed higher agreement than pairs that were not as homogeneous.