Abstract：
OBJECTIVES:To assess whether the reported trial characteristics are associated with treatment effects on all-cause mortality within critical care medicine. STUDY DESIGN AND SETTING:We identified all eligible randomized controlled trials (RCTs) from Cochrane Reviews on patients with sepsis, septic shock, and cardiogenic shock. Risk of bias was judged on 12 trial characteristics, including the differentiation between single-center and multicenter trials. Hierarchical random-effects models quantified the impact of the risk of bias items on the reported effect estimates of mortality. RESULTS:Twelve meta-analyses that involved 82 RCTs were selected and judged. Single-center trials estimated a significant larger treatment effect compared with multicenter trials (ratio of odds ratios, 0.64; 95% confidence interval: 0.47, 0.87). Treatment effect tended to be overestimated with selective reporting of preplanned end points. Biases in different trial characteristics are unlikely to operate independently and may have modified these associations. CONCLUSION:The results of this study highlight a substantial difference in treatment effect estimates between single-center and multicenter trials. Therefore, we recommend that results from single-center trials should be cautiously used for decision making.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Unverzagt S,Prondzinsky R,Peinemann Fdoi
10.1016/j.jclinepi.2013.05.016subject
Has Abstractpub_date
2013-11-01 00:00:00pages
1271-80issue
11eissn
0895-4356issn
1878-5921pii
S0895-4356(13)00204-7journal_volume
66pub_type
杂志文章,评审abstract：:Meta-analysis seems to have a potentially useful role in carefully selected situations where the primary literature is of good quality, heterogeneity in the response to treatment of the tested population is small and well-understood, interest centers on estimation of a specific, critical parameter of outcome, and the ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/0895-4356(94)00149-k
更新日期：1995-01-01 00:00:00
abstract：OBJECTIVES:To evaluate whether noninferiority trials are designed to adequately preserve the historical treatment effect of their active comparators. STUDY DESIGN AND SETTING:We reviewed 162 noninferiority trials published in high-impact medical journals. We assessed whether trials were designed to ensure that interve...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2019.03.003
更新日期：2019-06-01 00:00:00
abstract：:We develop a stochastic model of screening for ovarian cancer with serum levels of the CA 125 radioimmunoassay, a tumor-specific marker. The natural history of the disease is constructed using a four stage model characterized by a multivariate distribution for duration in each stage. Preserving its important features,...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(91)90075-k
更新日期：1991-01-01 00:00:00
abstract：OBJECTIVES:To illustrate how multiple hypotheses testing can produce associations with no clinical plausibility. STUDY DESIGN AND SETTING:We conducted a study of all 10,674,945 residents of Ontario aged between 18 and 100 years in 2000. Residents were randomly assigned to equally sized derivation and validation cohort...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2006.01.012
更新日期：2006-09-01 00:00:00
abstract：:Prediction models are developed to aid health care providers in estimating the probability or risk that a specific disease or condition is present (diagnostic models) or that a specific event will occur in the future (prognostic models), to inform their decision making. However, the overwhelming evidence shows that th...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2014.11.010
更新日期：2015-02-01 00:00:00
abstract：OBJECTIVE:To determine the status of dementia care services and workforce in selected public and private hospitals and geriatric care facilities in the Philippines. STUDY DESIGN AND SETTING:Framework analysis of 54 key informant interviews, 4 focus group discussions, and survey of 167 workers in 26 purposively selecte...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2018.06.010
更新日期：2018-10-01 00:00:00
abstract：:Cancer mortality from 1986 to 1992 was examined in a cohort of 4419 individuals who had been residing in an area of the municipality of Reggio Emilia, northern Italy, where tap water with unusually high selenium content was accidentally supplied. Mortality for all cancers was not significantly different, both in males...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(95)00014-u
更新日期：1995-09-01 00:00:00
abstract：:This article (Part II) and the preceding article (Part I) report the development of two clinical staging systems for HIV-infected individuals. The objective of the research reported here (Part II) was to construct a clinical staging system to predict survival in patients with AIDS. We analyzed data from VA Cooperative...
journal_title：Journal of clinical epidemiology
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1016/s0895-4356(97)00182-0
更新日期：1997-11-01 00:00:00
abstract：OBJECTIVES:Calibration is often thought to assess the bias of a clinical prediction rule. In particular, if the rule is based on a linear logistic model, it is often assumed that an overestimation of all coefficients results in a calibration slope less than 1 and an underestimation in a slope larger than 1. STUDY DESI...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2013.06.003
更新日期：2013-11-01 00:00:00
abstract：:We analyzed data from outpatients with chronic low back pain (LBP) in the Veterans Health Study (n = 563) to examine the relationship between localized LBP intensity and radiating leg pain in assessing patient functional status, low back disability, and use of diagnostic imaging. Based on the localized LBP intensity, ...
journal_title：Journal of clinical epidemiology
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1016/s0895-4356(99)00094-3
更新日期：1999-11-01 00:00:00
abstract：:We assessed validity and reliability of data on four serious pregnancy complications and gestational age in two national registers, the Medical Birth Register (MBR) and the National Register of Hospital Discharges (NRHD). From a cohort of all women in Denmark who gave birth to their first and second singleton infant i...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(96)00018-2
更新日期：1996-08-01 00:00:00
abstract：OBJECTIVE:Secondary databases are used in descriptive studies of patient subgroups; evaluation of associations between individual characteristics and diagnosis, prognosis, and/or service utilization rates; and studies of the quality of health care delivered. This article identifies sources of bias for health state char...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2006.08.012
更新日期：2007-07-01 00:00:00
abstract：:Although CHF has been considered a risk factor for venous thromboembolism, this has not been directly studied. We hypothesized that congestive heart failure would increase the risk of venous thromboembolism in an outpatient population, and that this risk would increase as patients' ventricular function worsened. We co...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(00)00373-5
更新日期：2001-08-01 00:00:00
abstract：:The purpose of this study was to describe patterns of health care use by inner-city patients with asthma and to identify patients at risk for hospitalization. We performed a retrospective cohort study of 1788 patients with asthma aged 5 to 34 years from a large hospital-based multi-specialty practice in inner-city Ind...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(96)00333-2
更新日期：1997-02-01 00:00:00
abstract：BACKGROUND:The impact of disease on population health is most commonly estimated by the population attributable fraction (PAF), or less commonly by the excess risk, an alternative measure that estimates the absolute risk of disease in the population that can be ascribed to the exposure. Using chronic airflow obstructio...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2017.10.020
更新日期：2018-01-01 00:00:00
abstract：OBJECTIVES:To determine what criteria researchers use to assess whether the estimates of effect of an intervention on a dichotomous outcome are different when obtained using different study designs. STUDY DESIGN AND SETTING:Scoping review of the literature. We included studies of dichotomous outcomes in which authors ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2016.02.001
更新日期：2016-07-01 00:00:00
abstract：:Plasma fibrinogen was measured in a sample of 8824 men and women aged 40-59 years participating in the Scottish Heart Health Study, and related to cardiovascular risk factors. Women had higher fibrinogen levels than men. In both sexes, multivariate analysis showed that fibrinogen was positively associated with age, sm...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(90)90075-z
更新日期：1990-01-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:To comprehensively examine comorbidity in unselected cohorts of patients with depression, stroke, multiple sclerosis (MS), Parkinson's disease/parkinsonism (PD/PKM), dementia, migraine, and epilepsy. METHODS:This cross-sectional study used morbidity data recorded by Dutch general practitioners...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2006.01.005
更新日期：2006-12-01 00:00:00
abstract：:The effect of age, sex, diabetes, hypertension, pulse rate and cigarette smoking on extracranial carotid artery plaque thickness evaluated by B-mode ultrasonography was investigated in a cross-sectional study of 698 white men, 730 white women, 77 black men and 76 black women as part of a clinical ultrasound registry. ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(89)90151-0
更新日期：1989-01-01 00:00:00
abstract：:We investigated asthma morbidity in children and adults among Registered Indians in Saskatchewan using hospitalization data for 1970-1989. In Registered Indians, significant increases were observed in the asthma hospitalization rates from 1979 to 1989 in boys and girls under 4 years, boys aged 5-14 years, and female a...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(95)00019-z
更新日期：1995-10-01 00:00:00
abstract：:A study was performed to determine the misclassification of information on exposure when surrogate informants are interviewed. Information from nondementia patients admitted to a geriatric ward was compared with that obtained from the patients' family members or friends (informants). Thirty-seven patients were recruit...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(96)00134-5
更新日期：1996-10-01 00:00:00
abstract：OBJECTIVE:Cases and controls should be chosen from the same base population to reduce selection bias in case-control studies. For hospital cases, we examined how inferences drawn from a case-control study can differ by choice of hospital- vs. community-based controls. STUDY DESIGN AND SETTINGS:We used data from a case...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2009.11.006
更新日期：2010-08-01 00:00:00
abstract：OBJECTIVES:To evaluate the responsiveness of generic and mapped preference-based measures based on the anchor of global change in health condition of colorectal cancer (CRC) patients. STUDY DESIGN AND SETTING:A baseline sample of 333 Chinese CRC patients was recruited between September 2009 and July 2010 and was surve...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2013.08.011
更新日期：2014-02-01 00:00:00
abstract：:The objective of this study was to assess the discriminative properties of the methods for diagnosing acute maxillary sinusitis (AMS) in unselected patients. The study design was a systematic review of evaluation studies identified by using Medline, by searching reference lists, by hand searches, and by contacting inv...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,meta分析
doi：10.1016/s0895-4356(99)00213-9
更新日期：2000-09-01 00:00:00
abstract：OBJECTIVE:To systematically review methodological articles which focus on nonpublication of studies and to describe methods of detecting and/or quantifying and/or adjusting for dissemination in meta-analyses. To evaluate whether the methods have been applied to an empirical data set for which one can be reasonably conf...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2016.04.015
更新日期：2016-12-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Podiatry (chiropody) services are one of the most frequently requested services in primary care. The elderly are given priority access to podiatry services in the UK blocking access for other priority groups. To evaluate the clinical and cost-effectiveness of a self-management program as a mea...
journal_title：Journal of clinical epidemiology
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0895-4356(03)00197-5
更新日期：2003-11-01 00:00:00
abstract：:The Busselton Survey is a population survey that is held about every three years. In 1994-1995 a re-survey was held of all past participants and 8,502 attended. Financial constraints precluded employing staff for data collection for blood pressure and anthropometry, these therefore were collected by unpaid lay volunte...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(01)00492-9
更新日期：2002-04-01 00:00:00
abstract：:The object of this study was to determine which attributes of clinical practice recommendations influence changes in clinical practice following audit and feedback. This was an observational study using multilevel modeling to examine the relationship between attributes of clinical practice recommendations and complian...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,多中心研究
doi：10.1016/s0895-4356(02)00403-1
更新日期：2002-07-01 00:00:00
abstract：:The aim was to assess relationships between increased aerobic fitness sustained over 4 years, and changes in blood pressure (SBP and DBP) and lipids. Measurements were made of BP, lipids, weight, and fitness in 1000 middle-aged men and women entering a fitness programme, and were repeated 2 and 4 years later. The 342 ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(93)90052-3
更新日期：1993-02-01 00:00:00
abstract：:More than one odds ratio estimate will often arise from a single epidemiologic study. Examples of designs where this may occur include those where there is more than one case or control group, and investigations of several risk factors as part of the same study. Various methods for presenting multiple interval estimat...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(89)90132-7
更新日期：1989-01-01 00:00:00
