Exploring the characteristics, methods and reporting of systematic reviews with meta-analyses of time-to-event outcomes: a meta-epidemiological study
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...
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2024-11-01
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| Online Access: | https://doi.org/10.1186/s12874-024-02401-4 |
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| author | Marius Goldkuhle Caroline Hirsch Claire Iannizzi Ana-Mihaela Zorger Ralf Bender Elvira C. van Dalen Lars G. Hemkens Ina Monsef Nina Kreuzberger Nicole Skoetz |
| author_facet | Marius Goldkuhle Caroline Hirsch Claire Iannizzi Ana-Mihaela Zorger Ralf Bender Elvira C. van Dalen Lars G. Hemkens Ina Monsef Nina Kreuzberger Nicole Skoetz |
| author_sort | Marius Goldkuhle |
| collection | DOAJ |
| 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. |
| format | Article |
| id | doaj-art-3cff55c79b854344aed22a295ea2fe35 |
| institution | OA Journals |
| issn | 1471-2288 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Research Methodology |
| spelling | doaj-art-3cff55c79b854344aed22a295ea2fe352025-08-20T02:08:25ZengBMCBMC Medical Research Methodology1471-22882024-11-0124111210.1186/s12874-024-02401-4Exploring the characteristics, methods and reporting of systematic reviews with meta-analyses of time-to-event outcomes: a meta-epidemiological studyMarius Goldkuhle0Caroline Hirsch1Claire Iannizzi2Ana-Mihaela Zorger3Ralf Bender4Elvira C. van Dalen5Lars G. Hemkens6Ina Monsef7Nina Kreuzberger8Nicole Skoetz9Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of CologneInstitute of Public Health, Faculty of Medicine and University Hospital Cologne, University of CologneInstitute of Public Health, Faculty of Medicine and University Hospital Cologne, University of CologneInstitute of Public Health, Faculty of Medicine and University Hospital Cologne, University of CologneDepartment of Medical Biometry, Institute for Quality and Efficiency in Health CarePrincess Máxima Center for Pediatric OncologyResearch Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of BaselInstitute of Public Health, Faculty of Medicine and University Hospital Cologne, University of CologneInstitute of Public Health, Faculty of Medicine and University Hospital Cologne, University of CologneInstitute of Public Health, Faculty of Medicine and University Hospital Cologne, University of CologneAbstract 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.https://doi.org/10.1186/s12874-024-02401-4Systematic reviewMeta-analysisTime-to-event outcomesSurvival analysisReporting qualityQuantitative analysis |
| spellingShingle | Marius Goldkuhle Caroline Hirsch Claire Iannizzi Ana-Mihaela Zorger Ralf Bender Elvira C. van Dalen Lars G. Hemkens Ina Monsef Nina Kreuzberger Nicole Skoetz Exploring the characteristics, methods and reporting of systematic reviews with meta-analyses of time-to-event outcomes: a meta-epidemiological study BMC Medical Research Methodology Systematic review Meta-analysis Time-to-event outcomes Survival analysis Reporting quality Quantitative analysis |
| title | Exploring the characteristics, methods and reporting of systematic reviews with meta-analyses of time-to-event outcomes: a meta-epidemiological study |
| title_full | Exploring the characteristics, methods and reporting of systematic reviews with meta-analyses of time-to-event outcomes: a meta-epidemiological study |
| title_fullStr | Exploring the characteristics, methods and reporting of systematic reviews with meta-analyses of time-to-event outcomes: a meta-epidemiological study |
| title_full_unstemmed | Exploring the characteristics, methods and reporting of systematic reviews with meta-analyses of time-to-event outcomes: a meta-epidemiological study |
| title_short | Exploring the characteristics, methods and reporting of systematic reviews with meta-analyses of time-to-event outcomes: a meta-epidemiological study |
| title_sort | exploring the characteristics methods and reporting of systematic reviews with meta analyses of time to event outcomes a meta epidemiological study |
| topic | Systematic review Meta-analysis Time-to-event outcomes Survival analysis Reporting quality Quantitative analysis |
| url | https://doi.org/10.1186/s12874-024-02401-4 |
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