Evidence map›Paper›PMID 32488906›Full record

SynthesisBritish journal of clinical pharmacology2020

Effect of low-dose aspirin on health outcomes: An umbrella review of systematic reviews and meta-analyses.

Nicola Veronese, Jacopo Demurtas, Trevor Thompson, Marco Solmi, Gabriella Pesolillo, Stefano Celotto, Tommaso Barnini, Brendon Stubbs, Stefania Maggi, Alberto Pilotto and 8 more

Open access · bronzeAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of clinical pharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 6 pooled it
3.6field-weighted citation impact, top 6% 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

14 citing papers in PubMed, 6 syntheses or guidelines pooled it, 34 citations in OpenAlex.

  1. Pooled it
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  7. Observational
  8. Sex as a major determinant of pro-longevity drug efficacy: a review of two decades of the NIA Interventions Testing Program.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025
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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

18 authors at 15 institutions in 6 countries.

Nicola VeroneseNational Research Council, Neuroscience Institute, Aging Branch, Padua, Italy.
Jacopo DemurtasPrimary Care Department, Azienda USL Toscana Sud Est, Grosseto, Italy.
Trevor ThompsonFaculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK.
Marco SolmiDepartment of Neuroscience, University of Padova, Padua, Italy.
Gabriella PesolilloPrimary Care Service, ASL 02, Chieti, Italy.
Stefano CelottoPrimary Care Department, Alto Friuli-Collinare-Medio Friuli, Udine, Italy.
Tommaso BarniniPrimary Care Service, AUSL Toscana Centro, Florence, Italy.
Brendon StubbsPhysiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK.
Stefania MaggiNational Research Council, Neuroscience Institute, Aging Branch, Padua, Italy.
Alberto PilottoGeriatrics Unit, Department of Geriatric Care, Ortho Geriatrics and Rehabilitation, Frailty Area, E.O. Galliera Hospital, Genoa, Italy.
Graziano OnderFondazione Policlinico Universitario A. Gemelli, IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy.
Evropi TheodoratouCentre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
Alberto VaonaPrimary Care Department, Azienda ULSS20 Verona, Verona, Italy.
Joseph FirthNICM Health Research Institute, University of Western Sydney, Penrith, Australia.
Lee SmithThe Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK.ORCID 0000-0003-0890-7566
Ai KoyanagiInstituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
John P A IoannidisStanford Prevention Research Center, Department of Medicine, Stanford University Medical School, Stanford, California, USA.
Ioanna TzoulakiCentre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
Anglia Ruskin University · GBEnte Ospedaliero Ospedali Galliera · ITAzienda Usl Toscana Centro · ITEdinburgh Cancer Research · GBInstituto de Salud Carlos III · ESKing's College London · GBNeuroscience Institute · ITPublic Health England · GBStanford Health Care · USUniversità Cattolica del Sacro Cuore · ITUniversity of Chieti-Pescara · ITUniversity of Manchester · GBUniversity of Modena and Reggio Emilia · ITUniversity of Padua · ITUniversity of Verona · IT

Funding

Cancer Research UK 22804Cancer Research UK C31250/A22804Department of Health ICA-CL-2017-03-001
6 · The paper itself

Abstract

aimsThis study aimed to use an umbrella review methodology to capture the range of outcomes that were associated with low-dose aspirin and to systematically assess the credibility of this evidence.

methodsAspirin is associated with several health outcomes, but the overall benefit/risk balance related to aspirin use is unclear. We searched three major databases up to 15 August 2019 for meta-analyses of observational studies and randomized controlled trials (RCTs) including low-dose aspirin compared to placebo or other treatments. Based on random-effects summary effect sizes, 95% prediction intervals, heterogeneity, small-study effects and excess significance, significant meta-analyses of observational studies were classified from convincing (class I) to weak (class IV). For meta-analyses of RCTs, outcomes with random effects P-value < .005 and a moderate/high GRADE assessment, were classified as strong evidence. From 6802 hits, 67 meta-analyses (156 outcomes) were eligible.

resultsObservational data showed highly suggestive evidence for aspirin use and increased risk of upper gastrointestinal bleeding (RR = 2.28, 95% CI: 1.97-2.64). In RCTs of low-dose aspirin, we observed strong evidence for lower risk of CVD in people without CVD (RR = 0.83; 95% CI: 0.79-0.87) and in general population (RR = 0.83; 95% CI: 0.79-0.89), higher risk of major gastrointestinal (RR = 1.47; 95% CI: 1.26-1.72) and intracranial bleeding (RR = 1.34; 95% CI: 1.18-1.53), and of major bleedings in people without CVD (RR = 1.62; 95% CI: 1.26-2.08).

conclusionCompared to other active medications, low-dose aspirin had strong evidence for lower risk of bleeding, but also lower comparative efficacy. Low-dose aspirin significantly lowers CVD risk and increases risk of bleeding. Evidence for multiple other health outcomes is limited.

Indexed as

AspirinGastrointestinal HemorrhageHumansRisk AssessmentAspirinaspirincancercardiovascular diseasemeta-analysisumbrella review

Identifiers

PMID32488906
PMCPMC7373714
OpenAlexW3030148622

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.