Intention-to-treat analysis: Are we managing dropouts and missing data properly in research on orthodontic treatment? A systematic review

2019 ◽  
Vol 155 (1) ◽  
pp. 19-27.e3 ◽  
Author(s):  
Klaus Barretto dos Santos Lopes Batista ◽  
Badri Thiruvenkatachari ◽  
Kevin O'Brien
Keyword(s):  
Systematic Review ◽  
Missing Data ◽  
Orthodontic Treatment ◽  
Intention To Treat ◽  
Treat Analysis

Methimazole-Induced Remission Rates in Pediatric Graves’ Disease: a Systematic Review

2021 ◽  
Author(s):  
Jelmer M van Lieshout ◽  
Christiaan F Mooij ◽  
A. S Paul van Trotsenburg ◽  
Nitash Zwaveling-Soonawala
Keyword(s):  
Systematic Review ◽  
Treatment Duration ◽  
Remission Rate ◽  
Graves Disease ◽  
Treatment Protocols ◽  
Intention To Treat ◽  
Remission Rates ◽  
One Year ◽  
Treat Analysis

Objective: Comparison of studies on remission rates in pediatric Graves’ disease is complicated by lack of uniformity in treatment protocols, remission definition, and follow-up duration. We performed a systematic review on remission rates in pediatric Graves’ disease and attempted to create uniformity by recalculating remission rates based on an intention-to-treat analysis. Methods: PubMed and Embase were searched in August 2020 for studies on patients with Graves’ disease (i) 2 to 18 years of age, (ii) initially treated with methimazole or carbimazole for at least 18 months, (iii) with a follow-up duration of at least one year after cessation of methimazole or carbimazole. All reported remission rates were recalculated using an intention-to-treat analysis. Results: Of 1,890 articles, 29 articles consisting of 24 patient cohorts, were included with a total of 3,057 patients (82.6% female). Methimazole or carbimazole was initially prescribed in 2,864 patients (93.7%). Recalculation based on intention-to-treat analysis resulted in an overall remission rate of 28.8% (829/2,880). Pooled remission rates based on treatment duration were 23.7%, 31.0%, 43.7%, and 75% after respectively 1.5-2.5 years, 2.5-5 years, 5-6 years (two studies), and 9 years (single study) treatment duration. Occurrence of adverse events was 419 in 2,377 patients (17.6%), with major side effects in 25 patients (1.1%). Conclusions: Using a standardized calculation the overall remission rate in methimazole treated pediatric GD is 28.8%. A few small studies indicate that longer treatment increases the remission rate. However, evidence is limited and further research is necessary to investigate the efficacy of longer treatment durations.

Intention-to-Treat Analysis and Accounting for Missing Data in Orthopaedic Randomized Clinical Trials

2009 ◽  
Vol 91 (9) ◽  
pp. 2137-2143 ◽  
Author(s):  
Amir Herman ◽  
Itamar Busheri Botser ◽  
Shay Tenenbaum ◽  
Ahron Chechick
Keyword(s):  
Clinical Trials ◽  
Missing Data ◽  
Randomized Clinical Trials ◽  
Intention To Treat ◽  
Treat Analysis

scholarly journals Characterization and Critical Appraisal of Physiotherapy Intervention Research in Nigeria: A Systematic Review

2021 ◽  
Author(s):  
Martins Nweke ◽  
Emeriewen Ejiroghene ◽  
Henrietta. O. Fawole ◽  
Mshunqane Nombeko
Keyword(s):  
Systematic Review ◽  
Clinical Research ◽  
Data Extraction ◽  
Controlled Trial ◽  
Eligibility Criteria ◽  
Intention To Treat ◽  
Clinical Innovation ◽  
Registration Number ◽  
Clinical Experiments ◽  
Treat Analysis

Abstract Objectives Clinical research is the bedrock of clinical innovation, education and practice. We characterized and critically appraised physiotherapy clinical research to avoid implementing misleading research findings into practice and to task the Nigerian physiotherapy societies on responsible conduct of clinical research. Methods This is a systematic review of articles published in English between 2009 and 2021. We searched Pubmed, Medline, Cumulative Index to Nursing and Allied Health Literature, Academic Search Complete, PsycINFO and African Journal Online, and reference lists of relevant articles. Data were selected and extracted according to predesigned eligibility criteria and using a standardized data extraction table. Where appropriate, the Pedro and Cochrane ROBINS1 were used to examine the risk of bias. Results Of the clinical experiments, the randomized controlled trial (RCT) was the most common design (87.5%). Musculoskeletal conditions (39.3%) were the most studied disorder. Most of the studies (76.8%) were of suboptimal quality. Interventions constituted exercise therapy (76.3%), manual therapy (8.5%) and electrotherapy (8.5%). More than half (67.8%) of the studies recorded medium to large effect sizes. A fair proportion (48.2%) of the studies had a confounding-by-indication bias. A few studies conducted normality tests (10.9%) and intention-to-treat analysis (37.5%). Discussion Of the clinical research, the volume of clinical experiments in the Nigeria Physiotherapy research community is small; notwithstanding, RCT is the most frequent clinical experiment. Physiotherapy interventions especially exercise appears effective, although incongruence between effect size and study quality limits inference. Sources of bias include absent/inadequate covariate analysis, blinding and intention-to-treat analysis approach. Registration: We registered the protocol with PROSPERO. The registration number: CRD42021228514.

Manual therapies for pain relief in patients with headache

2015 ◽  
Vol 23 (1) ◽  
pp. 89-96
Author(s):  
Débora Wanderley ◽  
Andrea Lemos ◽  
Larissa de Andrade Carvalho ◽  
Daniella Araújo de Oliveira
Keyword(s):  
Treatment Effect ◽  
Cervicogenic Headache ◽  
Allocation Concealment ◽  
Tension Type Headache ◽  
Manual Therapies ◽  
Osteopathic Manipulation ◽  
Intention To Treat ◽  
Headache Relief ◽  
Type Headache ◽  
Treat Analysis

Objective. This systematic review aimed to assess the efficacy of manual therapies for headache relief. Method. A systematic search in MEDLINE, LILACS, Cochrane, CINAHL, Scopus and Web of Sci­ence databases was conducted for randomized and quasi-randomized trials, with no restrictions for language or year of publication. The de­scriptors were ‘Headache’, ‘Headache disorders’ and ‘Musculoskeletal manipulations’, in addition to the keyword ‘Manual therapy’ and its equivalents in Portuguese. We included studies that compared mas­sage, chiropractic manipulation, osteopathic manipulation and other spinal manipulation to groups with no intervention, other physiother­apeutic modalities or to a sham group. Results. Seven of the 567 ar­ticles initially screened were selected, including patients with tension type headache, cervicogenic headache or migraine. It was not possible to assess the magnitude of the treatment effect on the findings of this review. The main limitations were the absence of randomization and adequate allocation concealment, the lack of blinded evaluators and intention-to-treat analysis and inadequate statistical analysis. Conclu­sions. We were unable to determine the size of the treatment effect due to the selective description of findings. Owing to the high risk of bias in the articles included, the available evidence regarding the ef­ficacy of manual therapies for headache relief is insufficient.

scholarly journals The Treatment Effect of Liver Transplantation versus Liver Resection for HCC: A Review and Future Perspectives

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3730
Author(s):  
Berend R. Beumer ◽  
Roeland F. de Wilde ◽  
Herold J. Metselaar ◽  
Robert A. de Man ◽  
Wojciech G. Polak ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Liver Resection ◽  
Early Stage ◽  
Disease Free Survival ◽  
Milan Criteria ◽  
Term Survival ◽  
Equal Distribution ◽  
Intention To Treat ◽  
Treat Analysis

For patients presenting with hepatocellular carcinoma within the Milan criteria, either liver resection or liver transplantation can be performed. However, to what extent either of these treatment options is superior in terms of long-term survival is unknown. Obviously, the comparison of these treatments is complicated by several selection processes. In this article, we comprehensively review the current literature with a focus on factors accounting for selection bias. Thus far, studies that did not perform an intention-to-treat analysis conclude that liver transplantation is superior to liver resection for early-stage hepatocellular carcinoma. In contrast, studies performing an intention-to-treat analysis state that survival is comparable between both modalities. Furthermore, all studies demonstrate that disease-free survival is longer after liver transplantation compared to liver resection. With respect to the latter, implications of recurrences for survival are rarely discussed. Heterogeneous treatment effects and logical inconsistencies indicate that studies with a higher level of evidence are needed to determine if liver transplantation offers a survival benefit over liver resection. However, randomised controlled trials, as the golden standard, are believed to be infeasible. Therefore, we suggest an alternative research design from the causal inference literature. The rationale for a regression discontinuity design that exploits the natural experiment created by the widely adopted Milan criteria will be discussed. In this type of study, the analysis is focused on liver transplantation patients just within the Milan criteria and liver resection patients just outside, hereby ensuring equal distribution of confounders.

Sign in / Sign up

Export Citation Format

Share Document