Evidence map›Paper›PMID 24473061›Full record

ReviewBMJ (Clinical research ed.)2013

Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study.

Huseyin Naci, John P A Ioannidis

Open access · hybridAbstract readComparative StudyReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Review in BMJ (Clinical research ed.), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 184 papers, 22 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
184citing papers in PubMed, 22 pooled it
46.7field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

184 citing papers in PubMed, 22 syntheses or guidelines pooled it, 631 citations in OpenAlex.

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  15. Aerobic exercise and cardiopulmonary fitness in childhood cancer survivors treated with a cardiotoxic agent: a meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2018
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  16. The 2017 Dutch Physical Activity Guidelines.The international journal of behavioral nutrition and physical activity · 2018
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124 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 2 countries.

Huseyin NaciLSE Health, London School of Economics and Political Science, London, UK.
John P A Ioannidis
Harvard University · USStanford University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the comparative effectiveness of exercise versus drug interventions on mortality outcomes.

designMetaepidemiological study. ELIGIBILITY CRITERIA: Meta-analyses of randomised controlled trials with mortality outcomes comparing the effectiveness of exercise and drug interventions with each other or with control (placebo or usual care). DATA SOURCES: Medline and Cochrane Database of Systematic Reviews, May 2013.

main outcome measureMortality. DATA SYNTHESIS: We combined study level death outcomes from exercise and drug trials using random effects network meta-analysis.

resultsWe included 16 (four exercise and 12 drug) meta-analyses. Incorporating an additional three recent exercise trials, our review collectively included 305 randomised controlled trials with 339,274 participants. Across all four conditions with evidence on the effectiveness of exercise on mortality outcomes (secondary prevention of coronary heart disease, rehabilitation of stroke, treatment of heart failure, prevention of diabetes), 14,716 participants were randomised to physical activity interventions in 57 trials. No statistically detectable differences were evident between exercise and drug interventions in the secondary prevention of coronary heart disease and prediabetes. Physical activity interventions were more effective than drug treatment among patients with stroke (odds ratios, exercise v anticoagulants 0.09, 95% credible intervals 0.01 to 0.70 and exercise v antiplatelets 0.10, 0.01 to 0.62). Diuretics were more effective than exercise in heart failure (exercise v diuretics 4.11, 1.17 to 24.76). Inconsistency between direct and indirect comparisons was not significant.

conclusionsAlthough limited in quantity, existing randomised trial evidence on exercise interventions suggests that exercise and many drug interventions are often potentially similar in terms of their mortality benefits in the secondary prevention of coronary heart disease, rehabilitation after stroke, treatment of heart failure, and prevention of diabetes.

Indexed as

Exercise TherapyAnticoagulantsCardiovascular AgentsComparative Effectiveness ResearchConfounding Factors, EpidemiologicCoronary DiseaseDiureticsFemaleHeart FailureHumansHypoglycemic AgentsMaleMortalityOdds RatioOutcome Assessment, Health CarePlatelet Aggregation InhibitorsAnticoagulantsCardiovascular AgentsDiureticsHypoglycemic AgentsPlatelet Aggregation Inhibitors

Identifiers

PMID24473061
PMCPMC3788175
OpenAlexW2902275236

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.