Evidence map›Paper›PMID 27370013›Full record

SynthesisEuropean journal of epidemiology2016

Comparison of treatment effect estimates of non-vitamin K antagonist oral anticoagulants versus warfarin between observational studies using propensity score methods and randomized controlled trials.

Guowei Li, Anne Holbrook, Yanling Jin, Yonghong Zhang, Mitchell A H Levine, Lawrence Mbuagbaw, Daniel M Witt, Mark Crowther, Stuart Connolly, Chatree Chai-Adisaksopha and 3 more

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in European journal of epidemiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 3 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

11 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Review
  6. Observational
  7. Article
  8. Article
  9. Article
  10. Article
  11. 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

13 authors.

Guowei LiDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. lig28@mcmaster.ca.
Anne HolbrookDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Yanling JinDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Yonghong ZhangDepartment of Epidemiology, School of Public Health, Soochow University, Suzhou, China.
Mitchell A H LevineDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Lawrence MbuagbawDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Daniel M WittDepartment of Pharmacotherapy, University of Utah, Salt Lake City, UT, USA.
Mark CrowtherDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Stuart ConnollyDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Chatree Chai-AdisaksophaDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Zhongxiao WanDepartment of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China.
Ji ChengDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Lehana ThabaneDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. thabanl@mcmaster.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Emerging observational studies using propensity score (PS) methods assessed real-world comparative effectiveness of non-vitamin K antagonist oral anticoagulants (NOACs) versus warfarin in patients with non-valvular atrial fibrillation (AF). We aimed to compare treatment effect estimates of NOACs between PS studies and randomized controlled trials (RCTs). Electronic databases and conference proceedings were searched systematically. Primary outcomes included stroke or systemic embolism (SE) and major bleeding. A random-effects meta-analysis was performed to synthesize the data by pooling the PS- and RCT-derived hazard ratios (HRs) separately. The ratio of HRs (RHR) from the ratio of PS-derived HRs relative to RCT-derived HRs was used to determine whether there was a difference between estimates from PS studies and RCTs. There were 10 PS studies and 5 RCTs included for analysis. No significant difference of treatment effect estimates between the PS studies and RCTs was observed: RHR 1.11, 95 % CI 0.98-1.23 for stroke or SE; RHR 1.07, 95 % CI 0.87-1.34 for major bleeding. A significant association between NOACs and risk of stroke or SE was observed: HR 0.88, 95 % CI 0.83-0.94 for the PS studies; HR 0.79, 95 % CI 0.72-0.87 for the RCTs. However, no relationship between NOACs and risk of major bleeding was found: HR 0.91, 95 % CI 0.79-1.05 for the PS studies; HR 0.85, 95 % CI 0.73-1.00 for the RCTs. In this study, treatment effect estimates of NOACs versus warfarin in patients with non-valvular AF from PS studies are found to be in agreement with those from RCTs.

Indexed as

Administration, OralAnticoagulantsAtrial FibrillationHumansPropensity ScoreRandomized Controlled Trials as TopicStrokeTreatment OutcomeVitamin KWarfarinAnticoagulantsVitamin KWarfarinAnticoagulantAtrial fibrillationPropensity score methodStrokeWarfarin

Identifiers

PMID27370013

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.