Evidence map›Paper›PMID 36703178›Full record

ArticleTrials2023

Mapping the methodological diversity of published drug discontinuation studies-a scoping review of study topics, objectives, and designs.

Nina Grede, Katrin Kuss, Ina Staudt, Norbert Donner-Banzhoff, Annika Viniol

Abstract readScoping Review
In one paragraph

Article in Trials, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. 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

5 authors.

Nina GredeDepartment of General Medicine, Preventive and Rehabilitation Medicine, University of Marburg, Karl-Von-Frisch Str. 4, 35043, Marburg, Germany. nina.grede@staff.uni-marburg.de.ORCID http://orcid.org/0000-0003-0213-9586
Katrin KussDepartment of General Medicine, Preventive and Rehabilitation Medicine, University of Marburg, Karl-Von-Frisch Str. 4, 35043, Marburg, Germany.
Ina StaudtDepartment of General Medicine, Preventive and Rehabilitation Medicine, University of Marburg, Karl-Von-Frisch Str. 4, 35043, Marburg, Germany.
Norbert Donner-BanzhoffDepartment of General Medicine, Preventive and Rehabilitation Medicine, University of Marburg, Karl-Von-Frisch Str. 4, 35043, Marburg, Germany.
Annika ViniolDepartment of General Medicine, Preventive and Rehabilitation Medicine, University of Marburg, Karl-Von-Frisch Str. 4, 35043, Marburg, Germany.

Funding

Bundesministerium für Bildung und Forschung 01KG1507
6 · The paper itself

Abstract

backgroundTrials evaluating drug discontinuation (drug discontinuation trials, DDTs) show a broad methodological spectrum. There are several specific methodological aspects in drug discontinuation trials (e.g., determination of research question; configuration of intervention; definition of outcomes). To verify this specifies, we did a scoping review about the study designs of drug discontinuation trials.

methodsA systematic literature search in Medline (PubMed), The Cochrane Library, EMBASE, CINAHL, Web of Science, and PsycINFO was performed. In a two-step selection process, we identified DDTs, which evaluate the discontinuation of one or more long-term medication as the investigated intervention, by two independent reviewers. Besides bibliographic data, we extracted several parameters to describe the used study design of the included DDTs: motivation for DDT, initially treatment aim of the discontinued medication, study design, methods of discontinuation, follow-up times, number of study participants, and outcome parameter.

resultsOut of 12,132 records, we included 581 DDTs. The most common motivation for doing a DDT were expected side effects (48.8%), the motivation of proving the efficacy of medication (21.6%), or doubts on the expected benefit of the used medication (13.8%). The majority of the discontinued medication was initially prescribed to improve the prognosis of a chronic disease (60.4%) or to relieve symptoms (31%). The study designs of the trials showed a broad methodological spectrum. The minority of the drug discontinuation trials were randomized controlled trials (34%).

conclusionThe results of this scoping review illustrates the need for an evidence-based methodological standard for planning and conducting drug discontinuation trials.

Indexed as

Pharmaceutical PreparationsRandomized Controlled Trials as TopicWithholding TreatmentHumansPharmaceutical PreparationsDrug discontinuationPolypharmacyPRISMA-ScRScoping reviewWithdrawal

Identifiers

PMID36703178
PMCPMC9878942

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.