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Systematic differences in effect estimates between observational studies and randomized control trials in
Miho Kimachi1, Akira Onishi2, Aran Tajika3
1Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan. kimachi.miho.5c@kyoto-u.jp.
Systematic reviews in nephrology are increasing. While observational studies and randomized controlled trials (RCTs) show similar effect estimates, their statistical significance often differs, impacting meta-analysis interpretations.
Area of Science:
- Nephrology
- Epidemiology
- Biostatistics
Background:
- Limited randomized controlled trials (RCTs) in nephrology hinder causal inference in meta-analyses.
- Systematic reviews increasingly incorporate observational studies due to RCT scarcity.
Purpose of the Study:
- To assess trends in systematic reviews of observational studies in nephrology from 2006-2016.
- To evaluate systematic differences in effect estimates between observational studies and RCTs within meta-analyses.
Main Methods:
- Conducted systematic reviews of comparative observational studies in nephrology (2006-2016).
- Analyzed meta-analyses combining observational studies and RCTs.
- Used ratio of odds ratios (ROR) and statistical significance discrepancies to compare study designs.
Main Results:
- The number of systematic reviews of observational studies in nephrology increased 11.7-fold over the decade.
- Ratio of odds ratios (ROR) indicated good agreement between study designs (1.05; 95% CI 0.90-1.23).
- Nearly half of the reviews showed discrepant interpretations regarding statistical significance.
Conclusions:
- Ratio of odds ratios (ROR) supports including observational studies in nephrology meta-analyses.
- Caution is advised due to frequent discrepancies in statistical significance interpretations between study designs.
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