Protocol for a Series of Systematic Reviews and Network Meta-analyses of Randomized Controlled Trials of Medications for Patients with Overactive Bladder Symptoms

Multiple randomized controlled trials (RCTs) have examined first-line pharmacological agents such as anticholinergics and β3 agonists for the management of overactive bladder symptoms (OAB). Although earlier systematic reviews and (network) meta-analyses aimed to summarize the evidence, a substantia...

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Main Authors: Henk van der Worp, Angie K. Puerto Nino, Marco H. Blanker, Romina Brignardello-Petersen, Gordon H. Guyatt, Kari A.O. Tikkinen, Arnav Agarwal, Yoshitaka Aoki, Scott R. Bauer, Neera Bhatnagar, Kostiantyn Bolsunovskyi, Gerhard H. te Brummelstroete, Jovita L. Cárdenas, Rufus Cartwright, Dean Elterman, Leyla Eryuzlu, Pramila Gaudel, Rachel E. Gutschon, Tomas L. Griebling, Sanna K. Hallamies, Katriina Heikkilä, Zain Izhar, Tuomas P. Kilpeläinen, Saqib Khurshid, Sanna M. Laakkonen, Yung Lee, Luciane C. Lopes, Anne Loohuis, Alexander Mendieta, Henri Mynttinen, Hanieh Salehi-Pourmehr, Alexey Pryalukhin, Mikolaj Przydacz, Fahad J. Siddiqui, Riikka Tähtinen, Robin W.M. Vernooij, Philippe D. Violette, Lambertus P.W. Witte, Koji Yoshimura
Format: Article
Language:English
Published: Elsevier 2024-11-01
Series:European Urology Open Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S266616832400630X
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author Henk van der Worp
Angie K. Puerto Nino
Marco H. Blanker
Romina Brignardello-Petersen
Gordon H. Guyatt
Kari A.O. Tikkinen
Arnav Agarwal
Yoshitaka Aoki
Scott R. Bauer
Neera Bhatnagar
Kostiantyn Bolsunovskyi
Gerhard H. te Brummelstroete
Jovita L. Cárdenas
Rufus Cartwright
Dean Elterman
Leyla Eryuzlu
Pramila Gaudel
Rachel E. Gutschon
Tomas L. Griebling
Sanna K. Hallamies
Katriina Heikkilä
Zain Izhar
Tuomas P. Kilpeläinen
Saqib Khurshid
Sanna M. Laakkonen
Yung Lee
Luciane C. Lopes
Anne Loohuis
Alexander Mendieta
Henri Mynttinen
Hanieh Salehi-Pourmehr
Alexey Pryalukhin
Mikolaj Przydacz
Fahad J. Siddiqui
Riikka Tähtinen
Robin W.M. Vernooij
Philippe D. Violette
Lambertus P.W. Witte
Koji Yoshimura
author_facet Henk van der Worp
Angie K. Puerto Nino
Marco H. Blanker
Romina Brignardello-Petersen
Gordon H. Guyatt
Kari A.O. Tikkinen
Arnav Agarwal
Yoshitaka Aoki
Scott R. Bauer
Neera Bhatnagar
Kostiantyn Bolsunovskyi
Gerhard H. te Brummelstroete
Jovita L. Cárdenas
Rufus Cartwright
Dean Elterman
Leyla Eryuzlu
Pramila Gaudel
Rachel E. Gutschon
Tomas L. Griebling
Sanna K. Hallamies
Katriina Heikkilä
Zain Izhar
Tuomas P. Kilpeläinen
Saqib Khurshid
Sanna M. Laakkonen
Yung Lee
Luciane C. Lopes
Anne Loohuis
Alexander Mendieta
Henri Mynttinen
Hanieh Salehi-Pourmehr
Alexey Pryalukhin
Mikolaj Przydacz
Fahad J. Siddiqui
Riikka Tähtinen
Robin W.M. Vernooij
Philippe D. Violette
Lambertus P.W. Witte
Koji Yoshimura
author_sort Henk van der Worp
collection DOAJ
description Multiple randomized controlled trials (RCTs) have examined first-line pharmacological agents such as anticholinergics and β3 agonists for the management of overactive bladder symptoms (OAB). Although earlier systematic reviews and (network) meta-analyses aimed to summarize the evidence, a substantial number of trials were not included, so a comprehensive and methodologically rigorous evaluation of the comparative effectiveness of all first-line pharmacological treatments is lacking. We aim to conduct a series of systematic reviews and network meta-analyses (NMAs) for a comprehensive assessment of the effectiveness and safety of first-line pharmacological treatments for OAB. Eligible studies will include RCTs comparing anticholinergics and β3 agonists to one another or to placebo in adults with OAB or detrusor overactivity. Pairs of reviewers with methodological training will independently evaluate candidate studies to determine eligibility and extract relevant data. We will incorporate patient-important outcomes, including urinary urgency episodes, urgency incontinence episodes, any type of incontinence episodes, urinary frequency, nocturia, and adverse events. We will conduct the NMAs using a frequentist framework and a graph theory model for each outcome. Analysis will follow rigorous methodologies, including handling of missing data and assessment of the risk of bias. We will conduct sensitivity and subgroup analyses and will apply the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to rate evidence certainty. Our approach aims to address the knowledge gap in the treatment of OAB by synthesizing evidence from RCTs worldwide. We will employ robust statistical methods, including frequentist NMA, to general clinically relevant and patient-important insights. Sensitivity and subgroup analyses will enhance the robustness and generalizability of our findings. Our reviews strive to inform evidence-based decisions in the management of OAB, to ultimate improve patient outcomes. Our study results may guide health policy decisions, such as reimbursement policies, and future studies in functional urology.The protocol for the review series is registered on PROSPERO as CRD42023266915.
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spelling doaj-art-c7c782b89a7f44da8006b3e5c32bcfe32025-08-20T02:10:50ZengElsevierEuropean Urology Open Science2666-16832024-11-0169899910.1016/j.euros.2024.08.006Protocol for a Series of Systematic Reviews and Network Meta-analyses of Randomized Controlled Trials of Medications for Patients with Overactive Bladder SymptomsHenk van der Worp0Angie K. Puerto Nino1Marco H. Blanker2Romina Brignardello-Petersen3Gordon H. Guyatt4Kari A.O. Tikkinen5Arnav AgarwalYoshitaka AokiScott R. BauerNeera BhatnagarKostiantyn BolsunovskyiGerhard H. te BrummelstroeteJovita L. CárdenasRufus CartwrightDean EltermanLeyla EryuzluPramila GaudelRachel E. GutschonTomas L. GrieblingSanna K. HallamiesKatriina HeikkiläZain IzharTuomas P. KilpeläinenSaqib KhurshidSanna M. LaakkonenYung LeeLuciane C. LopesAnne LoohuisAlexander MendietaHenri MynttinenHanieh Salehi-PourmehrAlexey PryalukhinMikolaj PrzydaczFahad J. SiddiquiRiikka TähtinenRobin W.M. VernooijPhilippe D. VioletteLambertus P.W. WitteKoji YoshimuraDepartment of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, The NetherlandsFaculty of Medicine, University of Helsinki, Helsinki, Finland; Division of Urology, Department of Surgery, University of Toronto, Toronto, Canada; Corresponding authors. Faculty of Medicine, University of Helsinki, Biomedicum 2B, P.O. Box 13, Tukholmankatu 8 B, 00290 Helsinki, Finland.Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, The NetherlandsDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, CanadaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada; Department of Medicine, McMaster University, Hamilton, CanadaFaculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada; Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Surgery, South Karelian Central Hospital, Lappeenranta, Finland; Corresponding authors. Faculty of Medicine, University of Helsinki, Biomedicum 2B, P.O. Box 13, Tukholmankatu 8 B, 00290 Helsinki, Finland.Multiple randomized controlled trials (RCTs) have examined first-line pharmacological agents such as anticholinergics and β3 agonists for the management of overactive bladder symptoms (OAB). Although earlier systematic reviews and (network) meta-analyses aimed to summarize the evidence, a substantial number of trials were not included, so a comprehensive and methodologically rigorous evaluation of the comparative effectiveness of all first-line pharmacological treatments is lacking. We aim to conduct a series of systematic reviews and network meta-analyses (NMAs) for a comprehensive assessment of the effectiveness and safety of first-line pharmacological treatments for OAB. Eligible studies will include RCTs comparing anticholinergics and β3 agonists to one another or to placebo in adults with OAB or detrusor overactivity. Pairs of reviewers with methodological training will independently evaluate candidate studies to determine eligibility and extract relevant data. We will incorporate patient-important outcomes, including urinary urgency episodes, urgency incontinence episodes, any type of incontinence episodes, urinary frequency, nocturia, and adverse events. We will conduct the NMAs using a frequentist framework and a graph theory model for each outcome. Analysis will follow rigorous methodologies, including handling of missing data and assessment of the risk of bias. We will conduct sensitivity and subgroup analyses and will apply the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to rate evidence certainty. Our approach aims to address the knowledge gap in the treatment of OAB by synthesizing evidence from RCTs worldwide. We will employ robust statistical methods, including frequentist NMA, to general clinically relevant and patient-important insights. Sensitivity and subgroup analyses will enhance the robustness and generalizability of our findings. Our reviews strive to inform evidence-based decisions in the management of OAB, to ultimate improve patient outcomes. Our study results may guide health policy decisions, such as reimbursement policies, and future studies in functional urology.The protocol for the review series is registered on PROSPERO as CRD42023266915.http://www.sciencedirect.com/science/article/pii/S266616832400630XOveractive bladderNetwork meta-analysisMultiple comparisonsTreatmentClinical outcomesRisk of bias
spellingShingle Henk van der Worp
Angie K. Puerto Nino
Marco H. Blanker
Romina Brignardello-Petersen
Gordon H. Guyatt
Kari A.O. Tikkinen
Arnav Agarwal
Yoshitaka Aoki
Scott R. Bauer
Neera Bhatnagar
Kostiantyn Bolsunovskyi
Gerhard H. te Brummelstroete
Jovita L. Cárdenas
Rufus Cartwright
Dean Elterman
Leyla Eryuzlu
Pramila Gaudel
Rachel E. Gutschon
Tomas L. Griebling
Sanna K. Hallamies
Katriina Heikkilä
Zain Izhar
Tuomas P. Kilpeläinen
Saqib Khurshid
Sanna M. Laakkonen
Yung Lee
Luciane C. Lopes
Anne Loohuis
Alexander Mendieta
Henri Mynttinen
Hanieh Salehi-Pourmehr
Alexey Pryalukhin
Mikolaj Przydacz
Fahad J. Siddiqui
Riikka Tähtinen
Robin W.M. Vernooij
Philippe D. Violette
Lambertus P.W. Witte
Koji Yoshimura
Protocol for a Series of Systematic Reviews and Network Meta-analyses of Randomized Controlled Trials of Medications for Patients with Overactive Bladder Symptoms
European Urology Open Science
Overactive bladder
Network meta-analysis
Multiple comparisons
Treatment
Clinical outcomes
Risk of bias
title Protocol for a Series of Systematic Reviews and Network Meta-analyses of Randomized Controlled Trials of Medications for Patients with Overactive Bladder Symptoms
title_full Protocol for a Series of Systematic Reviews and Network Meta-analyses of Randomized Controlled Trials of Medications for Patients with Overactive Bladder Symptoms
title_fullStr Protocol for a Series of Systematic Reviews and Network Meta-analyses of Randomized Controlled Trials of Medications for Patients with Overactive Bladder Symptoms
title_full_unstemmed Protocol for a Series of Systematic Reviews and Network Meta-analyses of Randomized Controlled Trials of Medications for Patients with Overactive Bladder Symptoms
title_short Protocol for a Series of Systematic Reviews and Network Meta-analyses of Randomized Controlled Trials of Medications for Patients with Overactive Bladder Symptoms
title_sort protocol for a series of systematic reviews and network meta analyses of randomized controlled trials of medications for patients with overactive bladder symptoms
topic Overactive bladder
Network meta-analysis
Multiple comparisons
Treatment
Clinical outcomes
Risk of bias
url http://www.sciencedirect.com/science/article/pii/S266616832400630X
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