Evidence map›Paper›PMID 27982726›Full record

Trial reportOphthalmic epidemiology2017

A Bayesian Analysis of a Randomized Clinical Trial Comparing Antimetabolite Therapies for Non-Infectious Uveitis.

Erica N Browne, Sivakumar R Rathinam, Anuradha Kanakath, Radhika Thundikandy, Manohar Babu, Thomas M Lietman, Nisha R Acharya

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Ophthalmic epidemiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.2field-weighted citation impact, top 19% 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

7 citing papers in PubMed, 11 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
  4. Prior Elicitation for Use in Clinical Trial Design and Analysis: A Literature Review.International journal of environmental research and public health · 2021
    Review
  5. Article
  6. Article
  7. Management of chronic ocular sarcoidosis: challenges and solutions.Clinical ophthalmology (Auckland, N.Z.) · 2018
    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

7 authors at 4 institutions in 2 countries.

Erica N Brownea F. I. Proctor Foundation, University of California, San Francisco , San Francisco , CA , USA.
Sivakumar R Rathinamb Aravind Eye Care System , Madurai , India.
Anuradha Kanakathc Aravind Eye Care System , Coimbatore , India.
Radhika Thundikandyb Aravind Eye Care System , Madurai , India.
Manohar Babuc Aravind Eye Care System , Coimbatore , India.
Thomas M Lietmana F. I. Proctor Foundation, University of California, San Francisco , San Francisco , CA , USA.
Nisha R Acharyaa F. I. Proctor Foundation, University of California, San Francisco , San Francisco , CA , USA.
Aravind Eye Hospital · INGlobal Brain Health Institute · USSan Francisco Foundation · USUniversity of California, San Francisco · US

Funding

First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uveitis TrialU10EY021125 · NEI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI ACHARYA, NISHA · 2012 to 2016
$4.6M
NEI NIH HHS U10 EY021125
6 · The paper itself

Abstract

purposeTo conduct a Bayesian analysis of a randomized clinical trial (RCT) for non-infectious uveitis using expert opinion as a subjective prior belief.

methodsA RCT was conducted to determine which antimetabolite, methotrexate or mycophenolate mofetil, is more effective as an initial corticosteroid-sparing agent for the treatment of intermediate, posterior, and pan-uveitis. Before the release of trial results, expert opinion on the relative effectiveness of these two medications was collected via online survey. Members of the American Uveitis Society executive committee were invited to provide an estimate for the relative decrease in efficacy with a 95% credible interval (CrI). A prior probability distribution was created from experts' estimates. A Bayesian analysis was performed using the constructed expert prior probability distribution and the trial's primary outcome.

resultsA total of 11 of the 12 invited uveitis specialists provided estimates. Eight of 11 experts (73%) believed mycophenolate mofetil is more effective. The group prior belief was that the odds of treatment success for patients taking mycophenolate mofetil were 1.4-fold the odds of those taking methotrexate (95% CrI 0.03-45.0). The odds of treatment success with mycophenolate mofetil compared to methotrexate was 0.4 from the RCT (95% confidence interval 0.1-1.2) and 0.7 (95% CrI 0.2-1.7) from the Bayesian analysis.

conclusionsA Bayesian analysis combining expert belief with the trial's result did not indicate preference for one drug. However, the wide credible interval leaves open the possibility of a substantial treatment effect. This suggests clinical equipoise necessary to allow a larger, more definitive RCT.

Indexed as

AdolescentAdultAnti-Inflammatory AgentsAntimetabolitesBayes TheoremFemaleHumansImmunosuppressive AgentsMaleMethotrexateMycophenolic AcidUveitisYoung AdultAnti-Inflammatory AgentsAntimetabolitesImmunosuppressive AgentsMethotrexateMycophenolic AcidAntimetaboliteBayesianclinical trialnon-infectious uveitisstatistics

Identifiers

PMID27982726
PMCPMC5738326
OpenAlexW2563955177

What OpenQuestion holds

Textmetadata
LicenceTDM
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.