Evidence map›Paper›PMID 32547244›Full record

ArticleClinical epidemiology2020

Meta-Analyses Proved Inconsistent in How Missing Data Were Handled Across Their Included Primary Trials: A Methodological Survey.

Lara A Kahale, Assem M Khamis, Batoul Diab, Yaping Chang, Luciane Cruz Lopes, Arnav Agarwal, Ling Li, Reem A Mustafa, Serge Koujanian, Reem Waziry and 6 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical epidemiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 25% 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
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

16 authors at 9 institutions in 7 countries.

Lara A KahaleClinical Research Institute, American University of Beirut, Beirut, Lebanon.ORCID 0000-0003-4466-0556
Assem M KhamisWolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK.ORCID 0000-0002-5567-7065
Batoul DiabClinical Research Institute, American University of Beirut, Beirut, Lebanon.
Yaping ChangDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.ORCID 0000-0002-9148-4877
Luciane Cruz LopesPharmaceutical Sciences Post Graduate Course, University of Sorocaba, UNISO, Sorocaba, Sao Paulo, Brazil.ORCID 0000-0002-3684-3275
Arnav AgarwalDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.ORCID 0000-0002-0931-7851
Ling LiChinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China.ORCID 0000-0001-7689-1856
Reem A MustafaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
Serge KoujanianDepartment of Evaluative Clinical Sciences, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Reem WaziryDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Jason W BusseDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.ORCID 0000-0002-0178-8712
Abeer DakikClinical Research Institute, American University of Beirut, Beirut, Lebanon.
Lotty HooftJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Gordon H GuyattDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
Rob J P M ScholtenJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Elie A AklClinical Research Institute, American University of Beirut, Beirut, Lebanon.ORCID 0000-0002-3444-8618
Impact · CAAmerican University of Beirut · LBUtrecht University · NLHarvard University · USSichuan University · CNSunnybrook Health Science Centre · CAUniversidade de Sorocaba · BRUniversity of Hull · GBUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHow systematic review authors address missing data among eligible primary studies remains uncertain.

objectiveTo assess whether systematic review authors are consistent in the way they handle missing data, both across trials included in the same meta-analysis, and with their reported methods.

methodsWe first identified 100 eligible systematic reviews that included a statistically significant meta-analysis of a patient-important dichotomous efficacy outcome. Then, we successfully retrieved 638 of the 653 trials included in these systematic reviews' meta-analyses. From each trial report, we extracted statistical data used in the analysis of the outcome of interest to compare with the data used in the meta-analysis. First, we used these comparisons to classify the "analytical method actually used" for handling missing data by the systematic review authors for each included trial. Second, we assessed whether systematic reviews explicitly reported their analytical method of handling missing data. Third, we calculated the proportion of systematic reviews that were consistent in their "analytical method actually used" across trials included in the same meta-analysis. Fourth, among systematic reviews that were consistent in the "analytical method actually used" across trials and explicitly reported on a method for handling missing data, we assessed whether the "analytical method actually used" and the reported methods were consistent.

resultsWe were unable to determine the "analytical method reviews actually used" for handling missing outcome data among 397 trials. Among the remaining 241, systematic review authors most commonly conducted "complete case analysis" (n=128, 53%) or assumed "none of the participants with missing data had the event of interest" (n=58, 24%). Only eight of 100 systematic reviews were consistent in their approach to handling missing data across included trials, but none of these reported methods for handling missing data. Among seven reviews that did explicitly report their analytical method of handling missing data, only one was consistent in their approach across included trials (using complete case analysis), and their approach was inconsistent with their reported methods (assumed all participants with missing data had the event).

conclusionThe majority of systematic review authors were inconsistent in their approach towards reporting and handling missing outcome data across eligible primary trials, and most did not explicitly report their methods to handle missing data. Systematic review authors should clearly identify missing outcome data among their eligible trials, specify an approach for handling missing data in their analyses, and apply their approach consistently across all primary trials.

Indexed as

assumptionmeta-analysismissing datarandomized controlled trialsystematic review

Identifiers

PMID32547244
PMCPMC7266325
OpenAlexW3028673208

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.