SynthesisBMC cancer2002
Erythropoietin, uncertainty principle and cancer related anaemia.
Synthesis in BMC cancer, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 6 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- The prognostic impact of decreased pretreatment haemoglobin level on the survival of patients with lung cancer: a systematic review and meta-analysis.BMC cancer · 2018Pooled it
- Industry sponsorship and research outcome.The Cochrane database of systematic reviews · 2017Pooled it
- Pooled it
- Pooled it
- Erythropoietin or darbepoetin for patients with cancer.The Cochrane database of systematic reviews · 2012Pooled it
- Erythropoietin or Darbepoetin for patients with cancer--meta-analysis based on individual patient data.The Cochrane database of systematic reviews · 2009Pooled it
- Lessons from the past: Long-term safety and survival outcomes of a prematurely terminated randomized controlled trial on prophylactic vs. hemoglobin-based administration of erythropoiesis-stimulating agents in patients with chemotherapy-induced anemia.Molecular and clinical oncology · 2016Article
- Comparator bias: why comparisons must address genuine uncertainties.Journal of the Royal Society of Medicine · 2013Article
- Management of paraneoplastic syndromes in lung cancer.Current treatment options in oncology · 2004Review
- Effect of haemopoietic growth factors on cancer cell lines and their role in chemosensitivity.Oncogene · 2004Article
- Clinical and economic impact of epoetins in cancer care.PharmacoEconomics · 2004Review
- Choosing a control intervention for a randomised clinical trial.BMC medical research methodology · 2003Article
- Molecular pathology of tumor metastasis III. Target array and combinatorial therapies.Pathology oncology research : POR · 2003Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study was designed to evaluate if erythropoietin (EPO) is effective in the treatment of cancer related anemia, and if its effect remains unchanged when data are analyzed according to various clinical and methodological characteristics of the studies. We also wanted to demonstrate that cumulative meta-analysis (CMA) can be used to resolve uncertainty regarding clinical questions.
methodsSystematic Review (SR) of the published literature on the role of EPO in cancer-related anemia. A cumulative meta-analysis (CMA) using a conservative approach was performed to determine the point in time when uncertainty about the effect of EPO on transfusion-related outcomes could be considered resolved.
participantsPatients included in randomized studies that compared EPO versus no therapy or placebo.
main outcome measuresNumber of patients requiring transfusions.
resultsNineteen trials were included. The pooled results indicated a significant effect of EPO in reducing the number of patients requiring transfusions [odds ratio (OR) = 0.41; 95%CI: 0.33 to 0.5; p < 0.00001;relative risk (RR) = 0.61; 95% CI: 0.54 to 0.68]. The results remain unchanged after the sensitivity analyses were performed according to the various clinical and methodological characteristics of the studies. The heterogeneity was less pronounced when OR was used instead of RR as the measure of the summary point estimate. Analysis according to OR was not heterogeneous, but the pooled RR was highly heterogeneous. A stepwise metaregression analysis did point to the possibility that treatment effect could have been exaggerated by inadequacy in allocation concealment and that larger treatment effects are seen at hb level > 11.5 g/dl. We identified 1995 as the point in time when a statistically significant effect of EPO was demonstrated and after which we considered that uncertainty about EPO efficacy was resolved.
conclusionEPO is effective in the treatment of anemia in cancer patients. This could have already been known in 1995 if a CMA had been performed at that time.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.