SynthesisBMC medical research methodology2018
Mediation analysis with a time-to-event outcome: a review of use and reporting in healthcare research.
Synthesis in BMC medical research methodology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
44 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Barriers and facilitators for the implementation of preventative mental health interventions among secondary schools in high-income countries: a systematic review.European child & adolescent psychiatry · 2025Pooled it
- A systematic review of mediation analysis frameworks in studies examining the determinants of cardiometabolic outcomes in people living with HIV.BMC medical research methodology · 2025Pooled it
- A Systematic Review of the Reporting Quality of Observational Studies That Use Mediation Analyses.Prevention science : the official journal of the Society for Prevention Research · 2022Pooled it
- The neurobiological cravings signature (NCS) as a predictive neuromarker of clinical outcomes in alcohol use disorder.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- Low genetic risk for coronary artery disease underlies multigenerational longevity and healthy aging.GeroScience · 2026Article
- Plant-based diet quality, fat mass, and cardiovascular disease: A mediation analysis of mid-aged adults in the UK Biobank.European journal of clinical nutrition · 2026Article
- Correlation between time pressure, emotional exhaustion, and children's behavioral problems among primary and secondary school homeroom teachers.Frontiers in public health · 2026Article
- SPAmix: a scalable, accurate, and universal analysis framework for large-scale genetic association studies in admixed populations.Genome biology · 2025Article
- Article
- Heterogeneous Exercise Responses to High-Intensity Interval Training Are Associated With Varied Long-Term Cardiovascular Outcomes in Patients With Heart Failure: A 15-Year Follow-Up.Journal of the American Heart Association · 2025Observational
- Stressful life events in childhood and adulthood and risk of physical, psychological and cognitive multimorbidities: a multicohort study.EClinicalMedicine · 2025Article
- Modeling the impact of socioeconomic disparity, biological markers and environmental exposures on phenotypic age using mediation analysis and structural equation models.International journal of medical informatics · 2025Article
- Air Pollution in Relation to COVID-19 Morbidity and Mortality: A Large Population-Based Cohort Study in Catalonia, Spain (COVAIR-CAT).Research report (Health Effects Institute) · 2024Article
- An assessment of the mediating role of hypertension in the effect of long-term air pollution exposure on dementia.Environmental epidemiology (Philadelphia, Pa.) · 2024Article
- Treatment condition as a moderator and change in trait mindfulness as a mediator of a brief mindfulness ecological momentary intervention for generalized anxiety disorder.European psychiatry : the journal of the Association of European Psychiatrists · 2024Article
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- Article
- High-Intensity Interval Training Is Associated With Improved 10-Year Survival by Mediating Left Ventricular Remodeling in Patients With Heart Failure With Reduced and Mid-Range Ejection Fraction.Journal of the American Heart Association · 2024Article
- NT-proBNP Mediates the Association Between FGF23 and All-Cause Mortality in Individuals With Type 2 Diabetes.Journal of the American Heart Association · 2023Article
- Circular extrachromosomal DNA promotes tumor heterogeneity in high-risk medulloblastoma.Nature genetics · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundMediation analysis tests whether the relationship between two variables is explained by a third intermediate variable. We sought to describe the usage and reporting of mediation analysis with time-to-event outcomes in published healthcare research.
methodsA systematic search of Medline, Embase, and Web of Science was executed in December 2016 to identify applications of mediation analysis to healthcare research involving a clinically relevant time-to-event outcome. We summarized usage over time and reporting of important methodological characteristics.
resultsWe included 149 primary studies, published from 1997 to 2016. Most studies were published after 2011 (n = 110, 74%), and the annual number of studies nearly doubled in the last year (from n = 21 to n = 40). A traditional approach (causal steps or change in coefficient) was most commonly taken (n = 87, 58%), and the majority of studies (n = 114, 77%) used a Cox Proportional Hazards regression for the outcome. Few studies (n = 52, 35%) mentioned any of the assumptions or limitations fundamental to a causal interpretation of mediation analysis.
conclusionThere is increasing use of mediation analysis with time-to-event outcomes. Current usage is limited by reliance on traditional methods and the Cox Proportional Hazards model, as well as low rates of reporting of underlying assumptions. There is a need for formal criteria to aid authors, reviewers, and readers reporting or appraising such studies.
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Registered trials
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.