Evidence map›Paper›PMID 38679615›Full record

SynthesisJournal of cancer research and clinical oncology2024

Systematic assessment of the influence of quality of studies on mistletoe in cancer care on the results of a meta-analysis on overall survival.

Jorina Hofinger, Lukas Kaesmann, Jens Buentzel, Martin Scharpenberg, Jutta Huebner

Abstract readMeta-Analysis
In one paragraph

Synthesis in Journal of cancer research and clinical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Combined Immune Checkpoint Blockade and HelixorInternational journal of molecular sciences · 2025
    Article
  2. Immune Checkpoint Blockade Combined with AbnobaViscumPharmaceuticals (Basel, Switzerland) · 2024
    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.

Jorina HofingerKlinik für Innere Medizin II, Hämatologie und Onkologie, Universitätsklinikum Jena, Jena, Germany. jorina.hofinger@outlook.de.ORCID http://orcid.org/0009-0007-7169-3915
Lukas KaesmannKlinik und Poliklinik für Strahlentherapie und Radioonkologie, Ludwig-Maximilians-Universität München, Munich, Germany.
Jens BuentzelKlinik für Hals‑Nasen‑Ohren‑Heilkunde, Südharzklinikum, Nordhausen, Germany.
Martin ScharpenbergKompetenzzentrum Für Klinische Studien, Universität Bremen, Bremen, Germany.
Jutta HuebnerKlinik für Innere Medizin II, Hämatologie und Onkologie, Universitätsklinikum Jena, Jena, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMistletoe treatment in cancer patients is controversial, and a Cochrane review concluded that due to heterogeneity, performing a meta-analysis was not suitable. However, several systematic reviews included meta-analyses in favor of mistletoe. The aim of this work was to assess the influence of the methodological quality of controlled studies on the results of a meta-analysis regarding overall survival.

methodsBetween April and August 2022, Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, CINAHL and Web of Science were systematically searched. In addition, reference lists of previously published meta-analyses were checked for relevant publications. A random effects meta-analysis with clustering was performed. The risk of bias within the studies was assessed using ROB 2.0 and ROBINS-I.

resultsThe search identified 4685 hits, and 28 publications reporting on 28 298 patients were included in the quantitative analysis. Overall, the analysis led to a significant result in favor of mistletoe therapy (overall HR = 0.61 with 95% CI [0.53;0.7]). According to our subgroup analysis of randomized studies, studies of higher quality (lower risk of bias) did not lead to a significant result in favor of mistletoe therapy (HR = 0.78; CI = [0.30; 2.00]).

conclusionsIn the case of mistletoe therapy, the results of the meta-analysis strongly depended on the methodological quality of the included studies. Calculating meta-analyses that include low-quality studies may lead to severe misinterpretation of the data.

Indexed as

MistletoeNeoplasmsHumansMeta-Analysis as TopicPhytotherapyRandomized Controlled Trials as TopicCancerMeta-analysisMethodological qualityMistletoe therapyOverall survivalRisk of bias

Identifiers

PMID38679615
PMCPMC11056339

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.