Evidence map›Paper›PMID 27022741›Full record

SynthesisPloS one2016

Propensity Score-Based Approaches to Confounding by Indication in Individual Patient Data Meta-Analysis: Non-Standardized Treatment for Multidrug Resistant Tuberculosis.

Gregory J Fox, Andrea Benedetti, Carole D Mitnick, Madhukar Pai, Dick Menzies, Collaborative Group for Meta-Analysis of Individual Patient Data in MDR-TB

Open access · goldAbstract readMeta-Analysis
In one paragraph

Synthesis in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
1.8field-weighted citation impact, top 12% 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

3 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Effectiveness of interventions for reducing TB incidence in countries with low TB incidence: a systematic review of reviews.European respiratory review : an official journal of the European Respiratory Society · 2019
    Pooled it
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Gregory J FoxRespiratory Epidemiology and Clinical Research Unit, McGill University, 2155 Guy St, Montreal, Quebec, H3H 2R9, Canada.
Andrea BenedettiRespiratory Epidemiology and Clinical Research Unit, McGill University, 2155 Guy St, Montreal, Quebec, H3H 2R9, Canada.
Carole D MitnickHarvard Medical School, 641 Huntington Avenue Boston, MA, 02115, United States of America.
Madhukar PaiDepartment of Epidemiology, Biostatistics & Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, H3A 1A2, Canada.
Dick MenziesRespiratory Epidemiology and Clinical Research Unit, McGill University, 2155 Guy St, Montreal, Quebec, H3H 2R9, Canada.
Collaborative Group for Meta-Analysis of Individual Patient Data in MDR-TB
McGill University · CAHarvard University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn the absence of randomized clinical trials, meta-analysis of individual patient data (IPD) from observational studies may provide the most accurate effect estimates for an intervention. However, confounding by indication remains an important concern that can be addressed by incorporating individual patient covariates in different ways. We compared different analytic approaches to account for confounding in IPD from patients treated for multi-drug resistant tuberculosis (MDR-TB).

methodsTwo antibiotic classes were evaluated, fluoroquinolones--considered the cornerstone of effective MDR-TB treatment--and macrolides, which are known to be safe, yet are ineffective in vitro. The primary outcome was treatment success against treatment failure, relapse or death. Effect estimates were obtained using multivariable and propensity-score based approaches.

resultsFluoroquinolone antibiotics were used in 28 included studies, within which 6,612 patients received a fluoroquinolone and 723 patients did not. Macrolides were used in 15 included studies, within which 459 patients received this class of antibiotics and 3,670 did not. Both standard multivariable regression and propensity score-based methods resulted in similar effect estimates for early and late generation fluoroquinolones, while macrolide antibiotics use was associated with reduced treatment success.

conclusionsIn this individual patient data meta-analysis, standard multivariable and propensity-score based methods of adjusting for individual patient covariates for observational studies yielded produced similar effect estimates. Even when adjustment is made for potential confounding, interpretation of adjusted estimates must still consider the potential for residual bias.

Indexed as

Confounding Factors, EpidemiologicPrecision MedicinePropensity ScoreAntitubercular AgentsFluoroquinolonesHumansMacrolidesModels, TheoreticalPatient SelectionTreatment OutcomeTuberculosis, Multidrug-ResistantAntitubercular AgentsFluoroquinolonesMacrolides

Identifiers

PMID27022741
PMCPMC4811416
OpenAlexW2329615048

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.