ArticleNeurocritical care2026
A Meta-epidemiologic Analysis of Differences in Treatment-Effect Estimates According to Outcome Scale (GOS vs. GOSE) in Moderate-to-Severe Traumatic Brain Injury Trials.
Article in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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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.
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Authors and funding
9 authors.
Funding
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Abstract
backgroundTraumatic brain injury (TBI) trials commonly assess global functional outcome using the Glasgow Outcome Scale (GOS) or Extended Glasgow Outcome Scale (GOSE). Because GOS- and GOSE-based trials are often pooled or compared in evidence synthesis, whether treatment-effect estimates differ systematically by outcome scale remains unresolved.
objectiveWe aim to estimate the between-trial contrast in treatment-effect estimates comparing GOSE-based with GOS-based randomized controlled trials (RCTs) of moderate-to-severe TBI.
methodsWe conducted a meta-epidemiologic analysis of RCTs comparing acute-phase interventions with a concurrent control in adults with moderate-to-severe TBI and reporting 6-month global functional outcome using GOS or GOSE. Random-effects meta-regression estimated the ratio of odds ratios (ROR) contrasting GOSE- with GOS-based trials, adjusted for publication year, multicenter status, income setting, intervention class, endpoint role, and sample size. Sensitivity, structural, and small-study-effect analyses were prespecified.
resultsEighty-four RCTs (> 20,000 participants) met eligibility criteria. Dichotomous outcomes were available for 78 trials (53 GOS and 26 GOSE observations). The adjusted outcome-scale contrast was ROR 0.880 [95% confidence interval (CI) 0.679-1.140; I
conclusionsGOS-based TBI trials yielded larger treatment-effect estimates than GOSE-based trials. Although directionally consistent across prespecified analyses, this pattern remained compatible with residual between-trial confounding and should not be interpreted causally. GOS- and GOSE-based treatment effects should not be assumed fully interchangeable in evidence synthesis. Meta-analyses spanning both scales should consider scale-stratified sensitivity analyses, and RCTs should justify and standardize outcome-scale ascertainment.
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Registered trials
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