Evidence map›Paper›PMID 39373266›Full record

ArticleJournal of evaluation in clinical practice2025

What is the probability that higher versus lower quality of evidence represents true effects estimates?

Benjamin Djulbegovic, Iztok Hozo, Despina Koletsi, Amy Price, David Nunan, Lars G Hemkens

Abstract read
In one paragraph

Article in Journal of evaluation in clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  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

6 authors.

Benjamin DjulbegovicDivision of Hematology/Oncology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.ORCID 0000-0003-0671-1447
Iztok HozoDepartment of Mathematics, Indiana University Northwest, Gary, Indiana, USA.
Despina KoletsiClinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
Amy PriceNuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, Oxford, UK.
David NunanPragmatic Evidence Lab, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland.
Lars G HemkensMeta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA.

Funding

AHRQ HHSAHRQ HHS R01 HS024917
6 · The paper itself

Abstract

RATIONALE, AIMS, AND

objectivesThe previous studies demonstrated that the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, a leading method for evaluating the certainty (quality) of scientific evidence (CoE), cannot reliably differentiate between various levels of CoE when the objective is to accurately assess the magnitude of the treatment effect. An estimated effect size is a function of multiple factors, including the true underlying treatment effect, biases, and other nonlinear factors that affect the estimate in different directions. We postulate that non-weighted, simple linear tallying can provide more accurate estimates of the probability of a true estimate of treatment effects as a function of CoE.

methodsWe reasoned that stable treatment effect estimates over time indicate truthfulness. We compared odds ratios (ORs) from meta-analyses (MAs) before and after updates, hypothesising that a ratio of odds ratios (ROR) equal to 1 will be more commonly observed in higher versus lower CoE. We used a subset of a previously analysed data set consisting of 82 Cochrane pairs of MAs in which CoE has not changed with the updated MA. If the linear model is valid, we would expect a decrease in the number of ROR = 1 cases as we move from high to moderate, low, and very low CoE.

resultsWe found a linear relationship between the probability of a potentially 'true' estimate of treatment effects as a function of CoE (assuming a 10% ROR error margin) (R

conclusionThis study confirmed linear relationship between CoE and the probability of potentially 'true' estimates. We found that the probability of potentially "true" estimates decreases by about 20% for each drop in CoE (from about 80% for high to 55% for moderate to 35% to low and 15% to very low CoE).

Indexed as

Evidence-Based MedicineMeta-Analysis as TopicHumansOdds RatioProbabilityevidence‐based medicinehierarchy of evidencetruth

Identifiers

PMID39373266
PMCPMC12020367

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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.