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...

Full description

Saved in:
Bibliographic Details
Main Authors: Marius Goldkuhle, Caroline Hirsch, Claire Iannizzi, Ana-Mihaela Zorger, Ralf Bender, Elvira C. van Dalen, Lars G. Hemkens, Ina Monsef, Nina Kreuzberger, Nicole Skoetz
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Medical Research Methodology
Subjects:
Online Access:https://doi.org/10.1186/s12874-024-02401-4
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850216055344988160
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
work_keys_str_mv AT mariusgoldkuhle exploringthecharacteristicsmethodsandreportingofsystematicreviewswithmetaanalysesoftimetoeventoutcomesametaepidemiologicalstudy
AT carolinehirsch exploringthecharacteristicsmethodsandreportingofsystematicreviewswithmetaanalysesoftimetoeventoutcomesametaepidemiologicalstudy
AT claireiannizzi exploringthecharacteristicsmethodsandreportingofsystematicreviewswithmetaanalysesoftimetoeventoutcomesametaepidemiologicalstudy
AT anamihaelazorger exploringthecharacteristicsmethodsandreportingofsystematicreviewswithmetaanalysesoftimetoeventoutcomesametaepidemiologicalstudy
AT ralfbender exploringthecharacteristicsmethodsandreportingofsystematicreviewswithmetaanalysesoftimetoeventoutcomesametaepidemiologicalstudy
AT elviracvandalen exploringthecharacteristicsmethodsandreportingofsystematicreviewswithmetaanalysesoftimetoeventoutcomesametaepidemiologicalstudy
AT larsghemkens exploringthecharacteristicsmethodsandreportingofsystematicreviewswithmetaanalysesoftimetoeventoutcomesametaepidemiologicalstudy
AT inamonsef exploringthecharacteristicsmethodsandreportingofsystematicreviewswithmetaanalysesoftimetoeventoutcomesametaepidemiologicalstudy
AT ninakreuzberger exploringthecharacteristicsmethodsandreportingofsystematicreviewswithmetaanalysesoftimetoeventoutcomesametaepidemiologicalstudy
AT nicoleskoetz exploringthecharacteristicsmethodsandreportingofsystematicreviewswithmetaanalysesoftimetoeventoutcomesametaepidemiologicalstudy