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Systematic assessment of the influence of quality of studies on mistletoe in cancer care on the results of a meta-analysis on overall survival

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Titel: Systematic assessment of the influence of quality of studies on mistletoe in cancer care on the results of a meta-analysis on overall survival
Autoren: Jorina Hofinger, Lukas Kaesmann, Jens Buentzel, Martin Scharpenberg, Jutta Huebner
Quelle: J Cancer Res Clin Oncol
Verlagsinformationen: Springer Science and Business Media LLC, 2024.
Publikationsjahr: 2024
Schlagwörter: 0301 basic medicine, 03 medical and health sciences, 0302 clinical medicine, Meta-Analysis as Topic, Research, Neoplasms, Cancer, Phytotherapy/methods [MeSH], Humans [MeSH], Neoplasms/mortality [MeSH], Overall survival, Meta-analysis, Risk of bias, Randomized Controlled Trials as Topic [MeSH], Neoplasms/drug therapy [MeSH], Mistletoe therapy, Neoplasms/therapy [MeSH], Mistletoe [MeSH], Meta-Analysis as Topic [MeSH], Methodological quality, Humans, Mistletoe, Phytotherapy, Randomized Controlled Trials as Topic
Beschreibung: Purpose Mistletoe treatment in cancer patients is controversial, and a Cochrane review concluded that due to heterogeneity, performing a meta-analysis was not suitable. However, several systematic reviews included meta-analyses in favor of mistletoe. The aim of this work was to assess the influence of the methodological quality of controlled studies on the results of a meta-analysis regarding overall survival. Methods Between April and August 2022, Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, CINAHL and Web of Science were systematically searched. In addition, reference lists of previously published meta-analyses were checked for relevant publications. A random effects meta-analysis with clustering was performed. The risk of bias within the studies was assessed using ROB 2.0 and ROBINS-I. Results The search identified 4685 hits, and 28 publications reporting on 28 298 patients were included in the quantitative analysis. Overall, the analysis led to a significant result in favor of mistletoe therapy (overall HR = 0.61 with 95% CI [0.53;0.7]). According to our subgroup analysis of randomized studies, studies of higher quality (lower risk of bias) did not lead to a significant result in favor of mistletoe therapy (HR = 0.78; CI = [0.30; 2.00]). Conclusions In the case of mistletoe therapy, the results of the meta-analysis strongly depended on the methodological quality of the included studies. Calculating meta-analyses that include low-quality studies may lead to severe misinterpretation of the data.
Publikationsart: Article
Other literature type
Sprache: English
ISSN: 1432-1335
DOI: 10.1007/s00432-024-05742-1
Zugangs-URL: https://pubmed.ncbi.nlm.nih.gov/38679615
https://repository.publisso.de/resource/frl:6496524
Rights: CC BY
Dokumentencode: edsair.doi.dedup.....4f2b3eec740d9d9b6bcb687c6d1b40e6
Datenbank: OpenAIRE
Beschreibung
Abstract:Purpose Mistletoe treatment in cancer patients is controversial, and a Cochrane review concluded that due to heterogeneity, performing a meta-analysis was not suitable. However, several systematic reviews included meta-analyses in favor of mistletoe. The aim of this work was to assess the influence of the methodological quality of controlled studies on the results of a meta-analysis regarding overall survival. Methods Between April and August 2022, Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, CINAHL and Web of Science were systematically searched. In addition, reference lists of previously published meta-analyses were checked for relevant publications. A random effects meta-analysis with clustering was performed. The risk of bias within the studies was assessed using ROB 2.0 and ROBINS-I. Results The search identified 4685 hits, and 28 publications reporting on 28 298 patients were included in the quantitative analysis. Overall, the analysis led to a significant result in favor of mistletoe therapy (overall HR = 0.61 with 95% CI [0.53;0.7]). According to our subgroup analysis of randomized studies, studies of higher quality (lower risk of bias) did not lead to a significant result in favor of mistletoe therapy (HR = 0.78; CI = [0.30; 2.00]). Conclusions In the case of mistletoe therapy, the results of the meta-analysis strongly depended on the methodological quality of the included studies. Calculating meta-analyses that include low-quality studies may lead to severe misinterpretation of the data.
ISSN:14321335
DOI:10.1007/s00432-024-05742-1