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Exploring the characteristics, methods and reporting of systematic reviews with meta-analyses of time-to-event outcomes: a meta-epidemiological study

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Title: Exploring the characteristics, methods and reporting of systematic reviews with meta-analyses of time-to-event outcomes: a meta-epidemiological study
Authors: Goldkuhle, Marius, Hirsch, Caroline, Iannizzi, Claire, Zorger, Ana-Mihaela, Bender, Ralf, van Dalen, Elvira C., Hemkens, Lars G., Monsef, Ina, Kreuzberger, Nina, Skoetz, Nicole
Source: BMC Med Res Methodol
BMC Medical Research Methodology, Vol 24, Iss 1, Pp 1-12 (2024)
Publisher Information: Springer Science and Business Media LLC, 2024.
Publication Year: 2024
Subject Terms: Medicine (General), Reporting quality, Research, Survival analysis, Time-to-event outcomes, Meta-analysis, Epidemiologic Studies, 03 medical and health sciences, R5-920, 0302 clinical medicine, Meta-Analysis as Topic, Research Design, Outcome Assessment, Health Care, Systematic review, Humans, Quantitative analysis, Research Design/standards [MeSH], Randomized Controlled Trials as Topic/standards [MeSH], Humans [MeSH], Outcome Assessment, Health Care/statistics, Epidemiologic Studies [MeSH], Randomized Controlled Trials as Topic/methods [MeSH], Outcome Assessment, Health Care/standards [MeSH], Outcome Assessment, Health Care/methods [MeSH], Randomized Controlled Trials as Topic/statistics, Meta-Analysis as Topic [MeSH], Research Design/statistics, Systematic Reviews as Topic/methods [MeSH], Systematic Reviews as Topic, Randomized Controlled Trials as Topic
Description: Background Time-to-event analysis is associated with methodological complexities. Previous research identified flaws in the reporting of time-to-event analyses in randomized trial publications. These hardships impose challenges for meta-analyses of time-to-event outcomes based on aggregate data. We examined the characteristics, reporting and methods of systematic reviews including such analyses. Methods Through a systematic search (02/2017-08/2020), we identified 50 Cochrane Reviews with ≥ 1 meta-analysis based on the hazard ratio (HR) and a corresponding random sample (n = 50) from core clinical journals (Medline; 08/02/2021). Data was extracted in duplicate and included outcome definitions, general and time-to-event specific methods and handling of time-to-event relevant trial characteristics. Results The included reviews analyzed 217 time-to-event outcomes (Median: 2; IQR 1–2), most frequently overall survival (41%). Outcome definitions were provided for less than half of time-to-event outcomes (48%). Few reviews specified general methods, e.g., included analysis types (intention-to-treat, per protocol) (35%) and adjustment of effect estimates (12%). Sources that review authors used for retrieval of time-to-event summary data from publications varied substantially. Most frequently reported were direct inclusion of HRs (64%) and reference to established guidance without further specification (46%). Study characteristics important to time-to-event analysis, such as variable follow-up, informative censoring or proportional hazards, were rarely reported. If presented, complementary absolute effect estimates calculated based on the pooled HR were incorrectly calculated (14%) or correct but falsely labeled (11%) in several reviews. Conclusions Our findings indicate that limitations in reporting of trial time-to-event analyses translate to the review level as well. Inconsistent reporting of meta-analyses of time-to-event outcomes necessitates additional reporting standards.
Document Type: Article
Other literature type
Language: English
ISSN: 1471-2288
DOI: 10.1186/s12874-024-02401-4
Access URL: https://pubmed.ncbi.nlm.nih.gov/39587509
https://doaj.org/article/3cff55c79b854344aed22a295ea2fe35
https://repository.publisso.de/resource/frl:6490999
Rights: CC BY
Accession Number: edsair.doi.dedup.....d4c6f6474adad34d1db334b1d9817d0c
Database: OpenAIRE
Description
Abstract:Background Time-to-event analysis is associated with methodological complexities. Previous research identified flaws in the reporting of time-to-event analyses in randomized trial publications. These hardships impose challenges for meta-analyses of time-to-event outcomes based on aggregate data. We examined the characteristics, reporting and methods of systematic reviews including such analyses. Methods Through a systematic search (02/2017-08/2020), we identified 50 Cochrane Reviews with ≥ 1 meta-analysis based on the hazard ratio (HR) and a corresponding random sample (n = 50) from core clinical journals (Medline; 08/02/2021). Data was extracted in duplicate and included outcome definitions, general and time-to-event specific methods and handling of time-to-event relevant trial characteristics. Results The included reviews analyzed 217 time-to-event outcomes (Median: 2; IQR 1–2), most frequently overall survival (41%). Outcome definitions were provided for less than half of time-to-event outcomes (48%). Few reviews specified general methods, e.g., included analysis types (intention-to-treat, per protocol) (35%) and adjustment of effect estimates (12%). Sources that review authors used for retrieval of time-to-event summary data from publications varied substantially. Most frequently reported were direct inclusion of HRs (64%) and reference to established guidance without further specification (46%). Study characteristics important to time-to-event analysis, such as variable follow-up, informative censoring or proportional hazards, were rarely reported. If presented, complementary absolute effect estimates calculated based on the pooled HR were incorrectly calculated (14%) or correct but falsely labeled (11%) in several reviews. Conclusions Our findings indicate that limitations in reporting of trial time-to-event analyses translate to the review level as well. Inconsistent reporting of meta-analyses of time-to-event outcomes necessitates additional reporting standards.
ISSN:14712288
DOI:10.1186/s12874-024-02401-4