Evidence mapPaperPMID 36129664Full record

SynthesisHormones (Athens, Greece)2022

Fragility of cardiovascular outcome trials (CVOTs) examining nutrition interventions among patients with diabetes mellitus: a systematic review of randomized controlled trials.

Niki Taouktsi, Stefanos T Papageorgiou, Georgios Tousinas, Stavroula Papanikolopoulou, Maria G Grammatikopoulou, George Giannakoulas, Dimitrios G Goulis

Open access · hybridAbstract readSystematic Review
In one paragraph

Synthesis in Hormones (Athens, Greece), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 46% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Niki TaouktsiMedical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Stefanos T PapageorgiouMedical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.ORCID http://orcid.org/0000-0001-9237-447X
Georgios TousinasUnit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, GR-56429, Greece.ORCID http://orcid.org/0000-0003-2272-6403
Stavroula PapanikolopoulouMedical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.ORCID http://orcid.org/0000-0002-4279-2187
Maria G GrammatikopoulouUnit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, GR-56429, Greece.ORCID http://orcid.org/0000-0003-4167-6595
George GiannakoulasDepartment of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.ORCID http://orcid.org/0000-0001-7491-6319
Dimitrios G GoulisUnit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, GR-56429, Greece. dgg@auth.gr.ORCID http://orcid.org/0000-0002-5005-1995
Aristotle University of Thessaloniki · GRUniversity of Thessaly · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThere is controversy regarding the optimal statistical method to interpret how robust is a statistically significant result. The fragility index (FI) and the reverse fragility index (RFI) are quantitative measures that can facilitate the appraisal of a clinical trial's robustness. This study was performed to evaluate the FI and RFI of randomized controlled trials (RCTs) examining nutritional interventions in patients with diabetes mellitus, focusing on cardiovascular outcomes.

methodsA systematic search was conducted and relevant RCTs were identified in three databases. RCTs examining nutritional interventions (supplements or dietary patterns) in patients with DM with dichotomous primary endpoints involving cardiovascular outcomes were eligible. Data were extracted to compose 2 × 2 event tables and the FI and RFI were calculated for each comparison, using Fisher's exact test. Risk of bias (RoB) of the included RCTs was assessed with the Cochrane RoB 2.0 tool.

resultsA total of 14,315 records were screened and 10 RCTs were included in the analyses. The median FI of the paired comparisons was 3 (IQR: 2-4) and the median RFI was 8 (IQR: 4.5-17). RoB and heterogeneity were low.

conclusionsRCTs examining nutritional interventions and cardiovascular outcomes among patients with diabetes mellitus appear to be statistically fragile. Τhe FI and the RFI can be reported and interpreted as an additional perspective of a trial's robustness. HIGHLIGHTS: • In the evidence-healthcare era, assessing how robust statistically significant results are remains a matter of controversy. • Recently, the fragility index (FI) and reverse fragility index (RFI) were proposed to assess the robustness of randomized controlled trials (RCTs) with 2 × 2 comparisons. • When applying the FI and RFI, RCTs examining nutritional interventions and cardiovascular outcomes among patients with diabetes mellitus (DM) appear to be statistically fragile. • Τhe FI and the RFI can be reported and interpreted as an additional perspective of a trial's robustness. • RCTs implementing nutrition interventions among patients with DM can improve their methodology.

Indexed as

Diabetes MellitusHumansRandomized Controlled Trials as TopicCardiovascular diseaseDietary supplementsFragility quotientMeta-epidemiologyRCTResearch methodologyStatistical robustness

Identifiers

PMID36129664
PMCPMC9712353
OpenAlexW4296967567

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

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 Socratic graph.