Evidence map›Paper›PMID 36988330›Full record

SynthesisInternational journal of stroke : official journal of the International Stroke Society2023

The credibility of subgroup analyses reported in stroke trials is low: A systematic review.

Ayoola Ademola, Lehana Thabane, Joel Adekanye, Ayooluwanimi Okikiolu, Samuel Babatunde, Mohammed A Almekhlafi, Bijoy K Menon, Michael D Hill, Kevin A Hildebrand, Tolulope T Sajobi

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal of stroke : official journal of the International Stroke Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

10 authors.

Ayoola AdemolaDepartment of Community Health Sciences and O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.ORCID 0000-0002-8412-6246
Lehana ThabaneDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Joel AdekanyeDepartment of Community Health Sciences and O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
Ayooluwanimi OkikioluDepartment Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
Samuel BabatundeOffice of Institutional Analysis, University of Calgary, Calgary, AB, Canada.
Mohammed A AlmekhlafiDepartment Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
Bijoy K MenonDepartment of Community Health Sciences and O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
Michael D HillDepartment of Community Health Sciences and O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.ORCID 0000-0002-6269-1543
Kevin A HildebrandDepartment of Surgery, University of Calgary, Calgary, AB, Canada.
Tolulope T SajobiDepartment of Community Health Sciences and O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSubgroup analyses are widely used to evaluate the heterogeneity of treatment effects in randomized clinical trials. However, there is a limited investigation of the quality of prespecified and reported subgroup analyses in stroke trials. This study evaluated the credibility of subgroup analyses in stroke trials. METHODS AND ANALYSIS: We searched Medline/PubMed, Embase, the Cochrane Central Register of Controlled Trials, and the Web of Science from inception to 24 March 2021. Three reviewers screened, extracted, and analyzed the data from the publications. Primary publications of stroke trials that reported at least one subgroup effect and had published corresponding study protocols were included. The Instrument for Assessing the Credibility of Effect Modification Analyses (ICEMAN) was used to examine the quality of the subgroup effects reported, with each subgroup effect assigned a credibility rating ranging from very low to high. Subgroup effects with two or more "definitely no" responses received a low credibility rating. The risk of bias was assessed using the Cochrane Risk-of-Bias tool for randomized trials version 2.

resultsSeventy-four articles met the inclusion criteria and reported a combined total of 647 subgroup effects. The median sample size was 1264 (interquartile range (IQR): 380-3876), and the median number of subgroups prespecified in the protocol was 6 (IQR: 2-10). Sixty-one (82%) studies used the univariate test of interaction. Of the total 647 subgroup effects reported in these studies, 319 (49%) were reported in acute stroke trials, while 423 (65%) had low credibility.

conclusionThe quality of subgroup analysis reporting in stroke trials remains poor. More effort is needed to train trialists on the best methods for designing and performing subgroup analyses, and how to report the results. TRIAL REGISTRATION NUMBER: We prospectively registered the review with International Prospective Register for Systematic Reviews (registration number: CRD42020223133).

Indexed as

StrokeClinical Trials as TopicHumansPubMedICEMANrandomized controlled trialstrokesubgroup analysisSystematic review

Identifiers

PMID36988330
PMCPMC10676048

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.