Evidence map›Paper›PMID 34210729›Full record

ArticleBMJ open2021

Identifying adults with acute rhinosinusitis in primary care that benefit most from antibiotics: protocol of an individual patient data meta-analysis using multivariable risk prediction modelling.

Roderick P Venekamp, Jeroen Hoogland, Maarten van Smeden, Maroeska M Rovers, An I De Sutter, Daniel Merenstein, Gerrit A van Essen, Laurent Kaiser, Helena Liira, Paul Little and 2 more

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 34% 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, 4 citations in OpenAlex.

  1. 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

12 authors at 8 institutions in 7 countries.

Roderick P VenekampJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands r.p.venekamp@umcutrecht.nl.ORCID 0000-0002-1446-9614
Jeroen HooglandJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Maarten van SmedenJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Maroeska M RoversRadboud Institute for Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands.
An I De SutterDepartment of Public Health and Primary Care, Ghent University, Ghent, Belgium.
Daniel MerensteinDepartment of Family Medicine, Georgetown University Medical Center, Washington, DC, USA.
Gerrit A van EssenGeneral Practitioner n.p, Amersfoort, The Netherlands.
Laurent KaiserDepartment of Medicine, Division of Infectious Diseases, University Hospital Geneva, Geneva, Switzerland.
Helena LiiraDepartment of General Practice, School of Primary, Aboriginal and Rural Health Care, University of Western Autralia, Perth, Western Australia, Australia.ORCID 0000-0001-6577-3109
Paul LittlePrimary Care & Population Sciences Unit, Aldermoor Health Centre, University of Southampton, Southampton, UK.ORCID 0000-0003-3664-1873
Heiner Cc BucherBasel Institute for Clinical Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland.
Johannes B ReitsmaJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Utrecht University · NLGeorgetown University · USGhent University · BERadboud University Nijmegen · NLUniversity Hospital of Geneva · CHUniversity of Basel · CHUniversity of Helsinki · FIUniversity of Southampton · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAcute rhinosinusitis (ARS) is a prime reason for doctor visits and among the conditions with highest antibiotic overprescribing rates in adults. To reduce inappropriate prescribing, we aim to predict the absolute benefit of antibiotic treatment for individual adult patients with ARS by applying multivariable risk prediction methods to individual patient data (IPD) of multiple randomised placebo-controlled trials. METHODS AND ANALYSIS: This is an update and re-analysis of a 2008 IPD meta-analysis on antibiotics for adults with clinically diagnosed ARS. First, the reference list of the 2018 Cochrane review on antibiotics for ARS will be reviewed for relevant studies published since 2008. Next, the systematic searches of CENTRAL, MEDLINE and Embase of the Cochrane review will be updated to 1 September 2020. Methodological quality of eligible studies will be assessed using the Cochrane Risk of Bias 2 tool. The primary outcome is cure at 8-15 days. Regression-based methods will be used to model the risk of being cured based on relevant predictors and treatment, while accounting for clustering. Such model allows for risk predictions as a function of treatment and individual patient characteristics and hence gives insight into individualised absolute benefit. Candidate predictors will be based on literature, clinical reasoning and availability. Calibration and discrimination will be evaluated to assess model performance. Resampling techniques will be used to assess internal validation. In addition, internal-external cross-validation procedures will be used to inform on between-study differences and estimate out-of-sample model performance. Secondarily, we will study possible heterogeneity of treatment effect as a function of outcome risk. ETHICS AND DISSEMINATION: In this study, no identifiable patient data will be used. As such, the Medical Research Involving Humans Subject Act (WMO) does not apply and official ethical approval is not required. Results will be submitted for publication in international peer-reviewed journals. PROSPERO REGISTRATION NUMBER: CRD42020220108.

Indexed as

RhinitisSinusitisAcute DiseaseAdultAnti-Bacterial AgentsHumansMeta-Analysis as TopicPrimary Health CareAnti-Bacterial Agentsepidemiologyotolaryngologyprimary care

Identifiers

PMID34210729
PMCPMC8252877
OpenAlexW3174587173

What OpenQuestion holds

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LicenceCC BY-NC
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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.