Evidence map›Paper›PMID 27079846›Full record

SynthesisJournal of clinical epidemiology2016

Evidence of nicotine replacement's effectiveness dissolves when meta-regression accommodates multiple sources of bias.

T D Stanley, Shelby Massey

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of clinical epidemiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors.

T D StanleyDepartment of Economics, Hendrix College, 1600 Washington, Conway, AR 72032, USA; Faculty of Arts and Education, Deakin University, 221 Burwood HWY, Burwood, Victoria 3125, Australia. Electronic address: Stanley@hendrix.edu.
Shelby MasseyOklahoma State University, College of Osteopathic Medicine, 1111 W. 17th St, Tulsa, OK 74107, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo accommodate and correct identifiable bias and risks of bias among clinical trials of nicotine replacement therapy (NRT). STUDY DESIGN AND

settingMeta-regression analysis of a published Cochrane Collaboration systematic review of 122 placebo-controlled clinical trials.

resultsBoth identified risks of bias and potential publication (or reporting or small sample) bias are associated with an increase in the reported effectiveness of NRT. Whenever multiple sources of biases are accommodated by meta-regression, no evidence of a practically notable or statistically significant overall increased rate of smoking cessation remains. Our findings are in stark contrast with the 50% to 70% increase in smoking cessation reported by the Cochrane Collaboration systematic review.

conclusionAfter more than 100 randomized clinical trials have been conducted, the overall effectiveness of NRT is in doubt. Simple, well-established meta-regression methods can test, accommodate, and correct multiple sources biases, often mentioned but dismissed by conventional systematic reviews.

Indexed as

BiasHumansRandomized Controlled Trials as TopicSmoking CessationTobacco Use Cessation DevicesTreatment OutcomeEgger regressionMeta-regressionNicotine replacement therapyPrecision-effect testPublication biasRisks of bias

Identifiers

PMID27079846

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.