Evidence map›Paper›PMID 27142846›Full record

ArticleSystematic reviews2016

Efficacy and safety of pharmacological agents in the treatment of erythema migrans in early Lyme borreliosis-systematic review protocol.

Gabriel Torbahn, Heidelore Hofmann, Roman Allert, Michael H Freitag, Rick Dersch, Volker Fingerle, Harriet Sommer, Edith Motschall, Jörg J Meerpohl, Christine Schmucker

Open access · goldAbstract read
In one paragraph

Article in Systematic reviews, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 18% 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, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Guideline
  2. Review
  3. Review
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

10 authors at 5 institutions in 1 country.

Gabriel TorbahnCochrane Germany, Medical Center-University of Freiburg, Berliner Allee 29, Freiburg, 79110, Germany. torbahn@cochrane.de.
Heidelore HofmannDepartment of Dermatology and Allergology, Technical University of Munich, Munich, Germany.
Roman AllertCochrane Germany, Medical Center-University of Freiburg, Berliner Allee 29, Freiburg, 79110, Germany.
Michael H FreitagDepartment of Health Services Research, University of Oldenburg, Oldenburg, Germany.
Rick DerschDepartment of Neurology, Medical Center-University of Freiburg, Freiburg, Germany.
Volker FingerleGerman National Reference Centre for Borrelia-Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany.
Harriet SommerCochrane Germany, Medical Center-University of Freiburg, Berliner Allee 29, Freiburg, 79110, Germany.
Edith MotschallInstitute for Medical Biometry and Statistics, Medical Center-University of Freiburg, Freiburg, Germany.
Jörg J MeerpohlCochrane Germany, Medical Center-University of Freiburg, Berliner Allee 29, Freiburg, 79110, Germany.
Christine SchmuckerCochrane Germany, Medical Center-University of Freiburg, Berliner Allee 29, Freiburg, 79110, Germany.
University Medical Center Freiburg · DEUniversity of Freiburg · DECarl von Ossietzky Universität Oldenburg · DEGoethe University Frankfurt · DETechnical University of Munich · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundErythema migrans represents an early cutaneous and most common manifestation of Lyme borreliosis. Recommendations regarding pharmacological agents, dose and duration of treatment are subject of intense debate. This review aims to explore differences in efficacy and safety between pharmacological treatments and control treatment.

methodsTo identify relevant studies, we will conduct a systematic literature search. We will include randomised controlled trials (RCTs) and non-RCTs. Eligible comparative studies need to (1) consider patients with a diagnosis of erythema migrans resulting from Lyme borreliosis and (2) compare different pharmacological agents against each other, against any other non-pharmacological treatment, placebo or no treatment. Two review authors will independently assess included studies for risk of bias according to the methods of the Cochrane Handbook for Systematic Reviews of Interventions and related to specific study designs. We will address patient-relevant outcomes including clinical remission of cutaneous symptoms, any treatment-related adverse events, quality of life and progressive symptoms such as neuroborreliosis or Lyme carditis and flu-like symptoms. Provided that the identified trials are comparable in terms of clinical issues, combined estimates will be provided. Estimations of treatment effects will be calculated based on a random effects model. Heterogeneity will be evaluated based on I (2) and chi-square test. In case of significant heterogeneity, a pooled estimate will not be provided, but heterogeneity will be investigated on the basis of methodological and clinical study aspects. We plan subgroup analysis to reveal potential differences in the effect estimates between patient populations and treatment specifications. We will consider risk of bias using sensitivity analyses to decide whether to rely on the pooled estimates. The quality of a body of evidence for individual outcomes will be assessed using the GRADE approach. DISCUSSION: Benefits and harms of pharmacological treatment in erythema migrans have not yet been adequately assessed. This systematic review will evaluate and summarise available evidence addressing benefits and harms of different pharmacological treatments. In addition, this summary of clinical evidence will inform decision-making between clinicians and patients and will play an important part in patient care. SYSTEMATIC REVIEW REGISTRATION: PROSPERO: CRD42016037932.

Indexed as

AmoxicillinAnti-Bacterial AgentsDisease ProgressionDoxycyclineDrug Administration ScheduleEarly Medical InterventionErythema Chronicum MigransHumansLyme DiseaseLyme NeuroborreliosisQuality of LifeSystematic Reviews as TopicTreatment OutcomeAmoxicillinAnti-Bacterial AgentsDoxycyclineDecision-makingErythema migransLyme borreliosisNon-RCTPharmacological treatmentRCTSkin manifestationSystematic review

Identifiers

PMID27142846
PMCPMC4855495
OpenAlexW2346704363

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.