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Adjustment of publication bias using a cumulative meta-analytic framework
W J Canestaro1,2, E B Devine1, A Bansal1
1School of Pharmacy, University of Washington, Seattle, WA, USA.
Summary
Publication bias delayed critical evidence on rosiglitazone and myocardial infarction (MI) risk by three years. Earlier access to all study data would have accelerated clinical decision-making, improving patient health outcomes.
Area of Science:
- Medical Research
- Clinical Epidemiology
- Biostatistics
Background:
- Publication bias can negatively impact clinical decisions and patient health.
- Incomplete evidence publication may lead to suboptimal medical choices.
Purpose of the Study:
- To determine if earlier publication of complete rosiglitazone myocardial infarction (MI) risk data would have altered clinical decision-making timelines.
- To assess the impact of publication bias on the time to reach a clinical decision threshold.
Main Methods:
- Conducted a cumulative meta-analysis (CMA) comparing published-only data with a comprehensive data set.
- Applied publication bias adjustment methods (Harbord regression, Peter's regression, trim and fill) to the limited data set.
- Compared the time to reach the decision threshold between the comprehensive and adjusted data sets.
Main Results:
- The comprehensive data set reached the clinical decision threshold 36 months earlier than the published-only data set.
- Final summary estimates for MI risk were similar between data sets (OR=1.4 vs. 1.42).
- Publication bias adjustment methods did not alter the time to the decision threshold compared to the published-only data.
Conclusions:
- Complete access to all rosiglitazone MI risk studies would have accelerated evidence reaching a clinically meaningful decision threshold by three years.
- Addressing publication bias is crucial for timely clinical decision-making and improved patient outcomes.
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