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Systematic reviews experience major limitations in reporting absolute effects.

Pablo Alonso-Coello1, Alonso Carrasco-Labra2, Romina Brignardello-Petersen3

  • 1Clinical Epidemiology and Public Health Department, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), C/ Sant Antoni Maria Claret, 167, Pavelló 18, planta 0, 08025 Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP); Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada.

Journal of Clinical Epidemiology
|November 13, 2015
PubMed
Summary
This summary is machine-generated.

Most systematic reviews (SRs) do not report absolute effect estimates, hindering clinical decision-making. When reported, absolute effect estimates are often inadequate, necessitating improved reporting standards for SR authors.

Keywords:
Absolute effect estimatesAbsolute measuresDecision makingFramingReportingRisk differenceSystematic review

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Area of Science:

  • Medical Informatics
  • Evidence-Based Medicine
  • Biostatistics

Background:

  • Relative effect estimates in systematic reviews (SRs) can inflate perceived treatment benefits.
  • The reporting and calculation methods for absolute effect estimates in SRs are not well understood.
  • Clear communication of treatment effects is crucial for informed clinical and patient decision-making.

Purpose of the Study:

  • To systematically survey SRs and describe the reporting and calculation of absolute effect estimates.
  • To identify factors associated with the reporting of absolute effect estimates in SRs.

Main Methods:

  • Independent screening and data extraction by two reviewers from Cochrane and non-Cochrane SRs.
  • Regression analyses were used to examine associations between study characteristics and absolute estimate reporting for patient-important outcomes.

Main Results:

  • Of 202 SRs, only 36.1% reported absolute effect estimates for the most patient-important outcome.
  • SRs with statistically significant effects were more likely to report absolute estimates (OR 2.26).
  • Commonly reported absolute estimates included risk percentages, number needed to treat, and natural frequencies.

Conclusions:

  • The majority of SRs inadequately report absolute effects, complicating interpretation for users.
  • SR authors should consistently report both absolute and relative effect estimates for all interventions.
  • Improved reporting of absolute effects is essential for optimizing the interpretation of SR findings.