Evidence map›Paper›PMID 28577540›Full record

SynthesisBMC medical research methodology2017

Overview of systematic reviews of therapeutic ranges: methodologies and recommendations for practice.

Lewis Cooney, Yoon K Loke, Su Golder, Jamie Kirkham, Andrea Jorgensen, Ian Sinha, Daniel Hawcutt

Abstract readSystematic Review
In one paragraph

Synthesis in BMC medical research methodology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–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

12 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Review
  5. Article
  6. Article
  7. Review
  8. Article
  9. TDM is dead. Long live TCI!British journal of clinical pharmacology · 2022
    Review
  10. Article
  11. Article
  12. 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

7 authors.

Lewis CooneyInstitute of Translational Medicine, University of Liverpool, Liverpool, Merseyside, UK.
Yoon K LokeSchool of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK.
Su GolderDepartment of Health Sciences, University of York, York, UK.
Jamie KirkhamDepartment of Biostatistics, University of Liverpool, Liverpool, UK.
Andrea JorgensenDepartment of Biostatistics, University of Liverpool, Liverpool, UK.
Ian SinhaRespiratory Department, Alder Hey Children's Hospital, Liverpool, UK.
Daniel HawcuttInstitute of Translational Medicine, University of Liverpool, Liverpool, Merseyside, UK. D.Hawcutt@liv.ac.uk.ORCID http://orcid.org/0000-0002-8120-6507

Funding

Department of Health PDF-2014-07-041
6 · The paper itself

Abstract

backgroundMany medicines are dosed to achieve a particular therapeutic range, and monitored using therapeutic drug monitoring (TDM). The evidence base for a therapeutic range can be evaluated using systematic reviews, to ensure it continues to reflect current indications, doses, routes and formulations, as well as updated adverse effect data. There is no consensus on the optimal methodology for systematic reviews of therapeutic ranges.

methodsAn overview of systematic reviews of therapeutic ranges was undertaken. The following databases were used: Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts and Reviews of Effects (DARE) and MEDLINE. The published methodologies used when systematically reviewing the therapeutic range of a drug were analyzed. Step by step recommendations to optimize such systematic reviews are proposed.

resultsTen systematic reviews that investigated the correlation between serum concentrations and clinical outcomes encompassing a variety of medicines and indications were assessed. There were significant variations in the methodologies used (including the search terms used, data extraction methods, assessment of bias, and statistical analyses undertaken). Therapeutic ranges should be population and indication specific and based on clinically relevant outcomes. Recommendations for future systematic reviews based on these findings have been developed.

conclusionEvidence based therapeutic ranges have the potential to improve TDM practice. Current systematic reviews investigating therapeutic ranges have highly variable methodologies and there is no consensus of best practice when undertaking systematic reviews in this field. These recommendations meet a need not addressed by standard protocols.

Indexed as

Evidence-Based MedicineReview Literature as TopicDose-Response Relationship, DrugDrug MonitoringDrug-Related Side Effects and Adverse ReactionsHumansOutcome Assessment, Health CarePharmaceutical PreparationsPharmaceutical PreparationsSystematic reviewSystematic review methodologyTherapeutic range

Identifiers

PMID28577540
PMCPMC5455119

What OpenQuestion holds

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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.