评价随机对照试验和队列研究在营养领域证据的一致性:一项元研究复制研究。

Evaluating agreement between evidence from randomised controlled trials and cohort studies in nutrition: a meta-research replication study.

机构信息

Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

出版信息

Eur J Epidemiol. 2024 Apr;39(4):363-378. doi: 10.1007/s10654-023-01058-5. Epub 2024 Jan 4.

Abstract

This meta-research study aims to evaluate the agreement of effect estimates between bodies of evidence (BoE) from RCTs and cohort studies included in the same nutrition evidence synthesis, to identify factors associated with disagreement, and to replicate the findings of a previous study. We searched Medline, Epistemonikos and the Cochrane Database of Systematic Reviews for nutrition systematic reviews that included both RCTs and cohort studies for the same patient-relevant outcome or intermediate-disease marker. We rated similarity of PI/ECO (population, intervention/exposure, comparison, outcome) between BoE from RCTs and cohort studies. Agreement of effect estimates across BoE was analysed by pooling ratio of risk ratios (RRR) for binary outcomes and difference of standardised mean differences (DSMD) for continuous outcomes. We performed subgroup and sensitivity analyses to explore determinants associated with disagreements. We included 82 BoE-pairs from 51 systematic reviews. For binary outcomes, the RRR was 1.04 (95% confidence interval (CI) 0.99 to 1.10, I = 59%, τ = 0.02, prediction interval (PI) 0.77 to 1.41). For continuous outcomes, the pooled DSMD was  - 0.09 (95% CI  - 0.26 to 0.09, PI  - 0.55 to 0.38). Subgroup analyses yielded that differences in type of intake/exposure were drivers towards disagreement. We replicated the findings of a previous study, where on average RCTs and cohort studies had similar effect estimates. Disagreement and wide prediction intervals were mainly driven by PI/ECO-dissimilarities. More research is needed to explore other potentially influencing factors (e.g. risk of bias) on the disagreement between effect estimates of both BoE.Trial registration: CRD42021278908.

摘要

本元研究旨在评估同一营养证据综合体内 RCT 和队列研究的证据体(BoE)之间效应估计的一致性,确定不一致的相关因素,并复制先前研究的结果。我们检索了 Medline、Epistemonikos 和 Cochrane 系统评价数据库,以查找同时包含 RCT 和队列研究的营养系统评价,这些研究针对相同的患者相关结局或中间疾病标志物。我们评估了 RCT 和队列研究的 BoE 之间的 PI/ECO(人群、干预/暴露、比较、结局)相似性。我们通过对二分类结局的风险比(RRR)和连续结局的标准化均数差(DSMD)进行汇总,来分析不同 BoE 之间效应估计的一致性。我们进行了亚组和敏感性分析,以探索与不一致相关的决定因素。我们纳入了 51 项系统评价中的 82 对 BoE。对于二分类结局,RRR 为 1.04(95%置信区间(CI)为 0.99 至 1.10,I=59%,τ=0.02,预测区间(PI)为 0.77 至 1.41)。对于连续结局,汇总的 DSMD 为-0.09(95%CI-0.26 至 0.09,PI-0.55 至 0.38)。亚组分析表明,摄入/暴露类型的差异是导致不一致的驱动因素。我们复制了先前研究的结果,即 RCT 和队列研究的平均效应估计相似。不一致和宽预测区间主要由 PI/ECO 不相似驱动。需要进一步研究来探索其他潜在的影响因素(例如,偏倚风险)对两种 BoE 之间效应估计的不一致性的影响。试验注册:CRD42021278908。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af60/11101378/6dfe8ab88014/10654_2023_1058_Fig1_HTML.jpg

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