ReviewBMJ (Clinical research ed.)2011
Prognostic effect size of cardiovascular biomarkers in datasets from observational studies versus randomised trials: meta-epidemiology study.
Review in BMJ (Clinical research ed.), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 8 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
24 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Healthcare outcomes assessed with observational study designs compared with those assessed in randomized trials: a meta-epidemiological study.The Cochrane database of systematic reviews · 2024Pooled it
- Trial-level characteristics associate with treatment effect estimates: a systematic review of meta-epidemiological studies.BMC medical research methodology · 2022Pooled it
- Systematic differences in effect estimates between observational studies and randomized control trials in meta-analyses in nephrology.Scientific reports · 2021Pooled it
- Global assessment of C-reactive protein and health-related outcomes: an umbrella review of evidence from observational studies and Mendelian randomization studies.European journal of epidemiology · 2021Pooled it
- Influence of food patterns on endothelial biomarkers: a systematic review.Journal of clinical hypertension (Greenwich, Conn.) · 2014Pooled it
- The clinical course of low back pain: a meta-analysis comparing outcomes in randomised clinical trials (RCTs) and observational studies.BMC musculoskeletal disorders · 2014Pooled it
- Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects.Journal of the American College of Cardiology · 2014Pooled it
- Using multiple types of studies in systematic reviews of health care interventions--a systematic review.PloS one · 2013Pooled it
- Neutrophil-to-lymphocyte ratio as a bladder cancer biomarker: Assessing prognostic and predictive value in SWOG 8710.Cancer · 2017Trial
- Biomarkers of Cardiovascular Stress: A Historical Review.Journal of cardiovascular development and disease · 2026Review
- Review
- Tutorial: dos and don'ts in clinical prediction research for venous thromboembolism.Research and practice in thrombosis and haemostasis · 2024Article
- Interval estimation for operating characteristic of continuous biomarkers with controlled sensitivity or specificity.Statistica Sinica · 2023Article
- Legume Intake Is Associated with Potential Savings in Coronary Heart Disease-Related Health Care Costs in Australia.Nutrients · 2022Article
- Discovery of primary prostate cancer biomarkers using cross cancer learning.Scientific reports · 2021Article
- A Critical Evaluation of Wet Biomarkers for Huntington's Disease: Current Status and Ways Forward.Journal of Huntington's disease · 2018Review
- Methodological Rigor in Preclinical Cardiovascular Studies: Targets to Enhance Reproducibility and Promote Research Translation.Circulation research · 2017Review
- Cancer biomarker discovery and validation.Translational cancer research · 2015Article
- Increasing value and reducing waste in research design, conduct, and analysis.Lancet (London, England) · 2014Article
- Meta-epidemiology.Epidemiology and health · 2014Article
Corrections and comments
- Commented on by
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the reported effect sizes of cardiovascular biomarkers in datasets from observational studies with those in datasets from randomised controlled trials.
designReview of meta-analyses. STUDY SELECTION: Meta-analyses of emerging cardiovascular biomarkers (not part of the Framingham risk score) that included datasets from at least one observational study and at least one randomised controlled trial were identified through Medline (last update, January 2011). DATA EXTRACTION: Study-specific risk ratios were extracted from all identified meta-analyses and synthesised with random effects for (a) all studies, and (b) separately for observational and for randomised controlled trial populations for comparison.
results31 eligible meta-analyses were identified. For seven major biomarkers (C reactive protein, non-HDL cholesterol, lipoprotein(a), post-load glucose, fibrinogen, B-type natriuretic peptide, and troponins), the prognostic effect was significantly stronger in datasets from observational studies than in datasets from randomised controlled trials. For five of the biomarkers the effect was less than half as strong in the randomised controlled trial datasets. Across all 31 meta-analyses, on average datasets from observational studies suggested larger prognostic effects than those from randomised controlled trials; from a random effects meta-analysis, the estimated average difference in the effect size was 24% (95% CI 7% to 40%) of the overall biomarker effect.
conclusionsCardiovascular biomarkers often have less promising results in the evidence derived from randomised controlled trials than from observational studies.
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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.