ArticleBMC medical research methodology2024
The necessity of validity diagnostics when drawing causal inferences from observational data: lessons from a multi-database evaluation of the risk of non-infectious uveitis among patients exposed to Remicade
Article in BMC medical research methodology, 2024. 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.
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.
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.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association of periodontitis and tooth loss with cognitive decline in the older adults - a systematic review.BMC oral health · 2026Pooled it
- From study design to executable code: automating target trial emulation with large language models.JAMIA open · 2026Article
- Precision public health: A natural experiment on chronic high-contrast PM2.5 exposure and pulmonary function among older adults.PloS one · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAutoimmune disorders have primary manifestations such as joint pain and bowel inflammation but can also have secondary manifestations such as non-infectious uveitis (NIU). A regulatory health authority raised concerns after receiving spontaneous reports for NIU following exposure to Remicade
methodsWe assessed the risk of NIU among patients exposed to Remicade
resultsOf the 80 total analyses and the 20 analyses pre-specified as primary, 24% and 20% passed diagnostics, respectively. Among patients with IBD, we observed no evidence of increased risk for NIU relative to other similarly indicated biologics (pooled hazard ratio [HR] 0.75, 95% confidence interval [CI] 0.38-1.40). For patients with RA, we observed no increased risk relative to similarly indicated biologics, although results were imprecise (HR: 1.23, 95% CI 0.14-10.47).
conclusionsWe applied validity diagnostics on a heterogenous, observational setting to answer a specific research question. The results indicated that safety effect estimates from many analyses would be inappropriate to interpret as causal, given the data available and methods employed. Validity diagnostics should always be used to determine if the design and analysis are of sufficient quality to support causal inferences. The clinical implications of our findings on IBD suggests that, if an increased risk exists, it is unlikely to be greater than 40% given the 1.40 upper bound of the pooled HR confidence interval.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.