Evidence map›Paper›PMID 33991101›Full record

SynthesisEuropean journal of orthodontics2021

Are treatment effect assumptions in orthodontic studies overoptimistic?

Jadbinder Seehra, Daniel Stonehouse-Smith, Martyn T Cobourne, Michail Tsagris, Nikolaos Pandis

Abstract readMeta-Analysis
In one paragraph

Synthesis in European journal of orthodontics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

5 authors.

Jadbinder SeehraDepartment of Orthodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Floor 25, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust, London, UK.ORCID 0000-0002-3243-1580
Daniel Stonehouse-SmithDepartment of Orthodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Floor 25, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust, London, UK.ORCID 0000-0002-1096-5012
Martyn T CobourneDepartment of Orthodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Floor 25, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust, London, UK.ORCID 0000-0003-2857-0315
Michail TsagrisDepartment of Economics, University of Crete, Rethimnon, Greece.
Nikolaos PandisDepartment of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Bern, Switzerland.

Funding

Department of Health
6 · The paper itself

Abstract

backgroundAt the clinical trial design stage, assumptions regarding the treatment effects to be detected should be appropriate so that the required sample size can be calculated. There is evidence in the medical literature that sample size assumption can be overoptimistic. The aim of this study was to compare the distribution of the assumed effects versus that of the observed effects as a proxy for overoptimistic treatment effect assumptions at the study design stage. MATERIALS AND

methodSystematic reviews (SRs) published between 1 January 2010 and 31 December 2019 containing at least one meta-analysis on continuous outcomes were identified electronically. SR and primary study level characteristics were extracted from the SRs and the individual trials. Details on the sample size calculation process and assumptions and the observed treatment effects were extracted.

resultsEighty-five SRs with meta-analysis containing 347 primary trials were included. The median number of SR authors was 5 (interquartile range: 4-7). At the primary study level, the majority were single centre (78.1%), utilized a parallel design (52%), and rated as an unclear/moderate level of risk of bias (34.3%). A sample size was described in only 31.7% (110/347) of studies. From this cohort of 110 studies, in only 37 studies was the assumed clinical difference that the study was designed to detect reported (37/110). The assumed treatment effect was recalculated for the remaining 73 studies (73/110). The one-sided exact signed rank test showed a significant difference between the assumed and observed treatment effects (P < 0.001) suggesting greater values for the assumed effect sizes.

conclusionsCareful consideration of the assumptions at the design stage of orthodontic studies are necessary in order to reduce the unreliability of clinical study results and research waste.

Indexed as

Research DesignHumans

Identifiers

PMID33991101
PMCPMC8488969

What OpenQuestion holds

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Registered trials

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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.