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Basic study design influences the results of orthodontic clinical investigations

Abstract Objectives Meta-analysis is the gold standard for synthesizing evidence on the effectiveness of health care interventions. However, its validity is dependent on the quality of included studies. Here, we investigated whether basic study design (i.e., randomization and timing of data collecti... Full description

Journal Title: Journal of clinical epidemiology 2015, Vol.68 (12), p.1512-1522
Main Author: Papageorgiou, Spyridon N
Other Authors: Xavier, Guilherme M , Cobourne, Martyn T
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: United States: Elsevier Inc
ID: ISSN: 0895-4356
Link: https://www.ncbi.nlm.nih.gov/pubmed/25910911
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recordid: cdi_proquest_miscellaneous_1735908269
title: Basic study design influences the results of orthodontic clinical investigations
format: Article
creator:
  • Papageorgiou, Spyridon N
  • Xavier, Guilherme M
  • Cobourne, Martyn T
subjects:
  • analysis
  • asjc
  • atira
  • Bias
  • Clinical trials
  • Confidence intervals
  • Data Collection
  • Data entry
  • Databases
  • Dental Research
  • Epidemiology
  • Humans
  • Internal Medicine
  • Medical care
  • Meta
  • Meta-analysis
  • omized controlled trial
  • Orthodontics
  • Patient Outcome Assessment
  • Prospective clinical study
  • Prospective Studies
  • pure
  • Quality management
  • Randomized controlled trial
  • Randomized Controlled Trials as Topic
  • Research Design
  • Research methodology
  • Retrospective clinical study
  • Retrospective Studies
  • Studies
  • subjectarea
  • Systematic review
ispartof: Journal of clinical epidemiology, 2015, Vol.68 (12), p.1512-1522
description: Abstract Objectives Meta-analysis is the gold standard for synthesizing evidence on the effectiveness of health care interventions. However, its validity is dependent on the quality of included studies. Here, we investigated whether basic study design (i.e., randomization and timing of data collection) in orthodontic research influences the results of clinical trials. Study Design and Setting This meta-epidemiologic study used unrestricted electronic and manual searching for meta-analyses in orthodontics. Differences in standardized mean differences (ΔSMD) between interventions and their 95% confidence intervals (CIs) were calculated according to study design through random-effects meta-regression. Effects were then pooled with random-effects meta-analyses. Results No difference was found between randomized and nonrandomized trials (25 meta-analyses; ΔSMD = 0.07; 95% CI = −0.21, 0.34; P  = 0.630). However, retrospective nonrandomized trials reported inflated treatment effects compared with prospective (40 meta-analyses; ΔSMD = −0.30; 95% CI = −0.53, −0.06; P  = 0.018). No difference was found between randomized trials with adequate and those with unclear/inadequate generation (25 meta-analyses; ΔSMD = 0.01; 95% CI = −0.25, 0.26; P  = 0.957). Finally, subgroup analyses indicated that the results of randomized and nonrandomized trials differed significantly according to scope of the trial (effectiveness or adverse effects; P  = 0.005). Conclusion Caution is warranted when interpreting systematic reviews investigating clinical orthodontic interventions when nonrandomized and especially retrospective nonrandomized studies are included in the meta-analysis.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0895-4356
fulltext: fulltext
issn:
  • 0895-4356
  • 1878-5921
url: Link


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descriptionAbstract Objectives Meta-analysis is the gold standard for synthesizing evidence on the effectiveness of health care interventions. However, its validity is dependent on the quality of included studies. Here, we investigated whether basic study design (i.e., randomization and timing of data collection) in orthodontic research influences the results of clinical trials. Study Design and Setting This meta-epidemiologic study used unrestricted electronic and manual searching for meta-analyses in orthodontics. Differences in standardized mean differences (ΔSMD) between interventions and their 95% confidence intervals (CIs) were calculated according to study design through random-effects meta-regression. Effects were then pooled with random-effects meta-analyses. Results No difference was found between randomized and nonrandomized trials (25 meta-analyses; ΔSMD = 0.07; 95% CI = −0.21, 0.34; P  = 0.630). However, retrospective nonrandomized trials reported inflated treatment effects compared with prospective (40 meta-analyses; ΔSMD = −0.30; 95% CI = −0.53, −0.06; P  = 0.018). No difference was found between randomized trials with adequate and those with unclear/inadequate generation (25 meta-analyses; ΔSMD = 0.01; 95% CI = −0.25, 0.26; P  = 0.957). Finally, subgroup analyses indicated that the results of randomized and nonrandomized trials differed significantly according to scope of the trial (effectiveness or adverse effects; P  = 0.005). Conclusion Caution is warranted when interpreting systematic reviews investigating clinical orthodontic interventions when nonrandomized and especially retrospective nonrandomized studies are included in the meta-analysis.
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subjectanalysis ; asjc ; atira ; Bias ; Clinical trials ; Confidence intervals ; Data Collection ; Data entry ; Databases ; Dental Research ; Epidemiology ; Humans ; Internal Medicine ; Medical care ; Meta ; Meta-analysis ; omized controlled trial ; Orthodontics ; Patient Outcome Assessment ; Prospective clinical study ; Prospective Studies ; pure ; Quality management ; Randomized controlled trial ; Randomized Controlled Trials as Topic ; Research Design ; Research methodology ; Retrospective clinical study ; Retrospective Studies ; Studies ; subjectarea ; Systematic review
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descriptionAbstract Objectives Meta-analysis is the gold standard for synthesizing evidence on the effectiveness of health care interventions. However, its validity is dependent on the quality of included studies. Here, we investigated whether basic study design (i.e., randomization and timing of data collection) in orthodontic research influences the results of clinical trials. Study Design and Setting This meta-epidemiologic study used unrestricted electronic and manual searching for meta-analyses in orthodontics. Differences in standardized mean differences (ΔSMD) between interventions and their 95% confidence intervals (CIs) were calculated according to study design through random-effects meta-regression. Effects were then pooled with random-effects meta-analyses. Results No difference was found between randomized and nonrandomized trials (25 meta-analyses; ΔSMD = 0.07; 95% CI = −0.21, 0.34; P  = 0.630). However, retrospective nonrandomized trials reported inflated treatment effects compared with prospective (40 meta-analyses; ΔSMD = −0.30; 95% CI = −0.53, −0.06; P  = 0.018). No difference was found between randomized trials with adequate and those with unclear/inadequate generation (25 meta-analyses; ΔSMD = 0.01; 95% CI = −0.25, 0.26; P  = 0.957). Finally, subgroup analyses indicated that the results of randomized and nonrandomized trials differed significantly according to scope of the trial (effectiveness or adverse effects; P  = 0.005). Conclusion Caution is warranted when interpreting systematic reviews investigating clinical orthodontic interventions when nonrandomized and especially retrospective nonrandomized studies are included in the meta-analysis.
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abstractAbstract Objectives Meta-analysis is the gold standard for synthesizing evidence on the effectiveness of health care interventions. However, its validity is dependent on the quality of included studies. Here, we investigated whether basic study design (i.e., randomization and timing of data collection) in orthodontic research influences the results of clinical trials. Study Design and Setting This meta-epidemiologic study used unrestricted electronic and manual searching for meta-analyses in orthodontics. Differences in standardized mean differences (ΔSMD) between interventions and their 95% confidence intervals (CIs) were calculated according to study design through random-effects meta-regression. Effects were then pooled with random-effects meta-analyses. Results No difference was found between randomized and nonrandomized trials (25 meta-analyses; ΔSMD = 0.07; 95% CI = −0.21, 0.34; P  = 0.630). However, retrospective nonrandomized trials reported inflated treatment effects compared with prospective (40 meta-analyses; ΔSMD = −0.30; 95% CI = −0.53, −0.06; P  = 0.018). No difference was found between randomized trials with adequate and those with unclear/inadequate generation (25 meta-analyses; ΔSMD = 0.01; 95% CI = −0.25, 0.26; P  = 0.957). Finally, subgroup analyses indicated that the results of randomized and nonrandomized trials differed significantly according to scope of the trial (effectiveness or adverse effects; P  = 0.005). Conclusion Caution is warranted when interpreting systematic reviews investigating clinical orthodontic interventions when nonrandomized and especially retrospective nonrandomized studies are included in the meta-analysis.
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pmid25910911
doi10.1016/j.jclinepi.2015.03.008
orcididhttps://orcid.org/0000-0003-1968-3326
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