Impact of data extraction errors in meta-analyses on the association between depression and peripheral inflammatory biomarkers: an umbrella review

Validity of data extraction in acupuncture meta-analysis: a reproducibility study protocol

INTRODUCTION

Systematic review and meta-analysis occupy the apex of the evidence pyramid, serving as the most comprehensive and reliable form of evidence-based assessment. Data extraction is a crucial juncture in meta-analysis, establishing the underpinnings for the outcomes and deductions drawn from systematic reviews (SRs). However, the frequency of data extraction errors in meta-analysis is quite significant. Data extraction errors can lead to biased study results, affect the credibility of study results and even mislead clinical practice. The quantity of acupuncture randomised controlled trials and SRs has expanded rapidly recently, yet the validity of data extraction remains unexplored. Hence, our study aims to investigate the validity of data extraction errors in acupuncture SRs, the effect of data extraction errors on results and the relevant guidelines used erroneous results.

METHODS AND ANALYSIS

Four databases including MEDLINE, Web of Science, Cochrane linbrary and EMBASE will be searched from 1 January 2019 to 31 December 2023 for acupuncture SRs. Two researchers will independently extract data from the meta-analysis and the original study into a standardised data extraction table. A senior investigator, who did not participate in the data extraction process, will verify the results. In cases of discrepancies, the senior researcher will conduct further extraction and consult with another senior researcher to determine the final results. We will analyse the frequency and type of data extraction errors and data estimation errors and evaluate the effect of data extraction errors on results. Quantile regression will be used to explore the factors influencing data extraction error frequency at 25th, 50th and 75th percentiles. Finally, we will further search for guidelines used erroneous results.

ETHICS AND DISSEMINATION

Ethical approval is not necessary for this study. This protocol has been registered in Open Science Framework Registries. REGISTRATION DOI: https://doi.org/10.17605/OSF.IO/CHMPA.

The Standard Error/Standard Deviation Mix-Up: Potential Impacts on Meta-Analyses in Sports Medicine

BACKGROUND

A recent review found that 45% of meta-analyses included statistical errors, of which, the most common was the calculation of effect sizes based on standard error (SE) rather than standard deviation (SD) [the SE/SD mix-up].

OBJECTIVES

The first aim of this study was to assess the impact of the SE/SD mix-up on the results of one highly cited meta-analysis. Our second aim was to identify one potential source of the SE/SD mix-up, by assessing how often SE is reported as a measure of sample variability in randomised controlled trials in sports medicine.

METHODS

We checked for potential SE/SD mix-ups in a 2015 meta-analysis of randomised controlled trials reporting the effects of recreational football interventions on aerobic fitness in adults. We corrected effect sizes affected by SE/SD mix-ups and re-analysed the data according to the original methodology. We compared pooled estimates of effect sizes from our re-analysis of corrected values with those of the original study. To assess how often SE was reported instead of SD as a measure of sample variance, we text mined results of randomised controlled trials from seven sports medicine journals and reported the proportion reporting of SE versus SD.

RESULTS

We identified potential SE/SD mix-ups in 9/16 effect sizes included in the meta-analysis describing the effects of football-based interventions versus non-exercise control. The published effect size was standardised mean difference (SMD) = 1.46 (95% confidence interval [CI] 0.91, 2.01). After correcting for SE/SD mix-ups, our re-analysis produced a smaller pooled estimate (SMD = 0.54 [95% CI 0.37, 0.71]). The original pooled estimate for trials comparing football versus running interventions was SMD = 0.68 (95% CI 0.06, 1.4). After correcting for SE/SD mix-ups and re-analysis, the effect was no longer statistically significant (SMD = 0.20 [95% CI - 0.10, 0.49)]). We found that 19.3% of randomised controlled trials reported SE rather than SD to describe sample variability. The relative frequency of the practice ranged from 0 to 25% across the seven journals sampled.

CONCLUSIONS

We found the SE/SD mix-up had inflated estimates for the effects of football on aerobic fitness. Meta-analysts should be vigilant to avoid miscalculating effect sizes. Authors, reviewers and editors should avoid and discourage (respectively) the practice of reporting SE as a measure of sample variability in sports medicine research.

Prevalence and Mortality Risk of Neurological Disorders during the COVID-19 Pandemic: An Umbrella Review of the Current Evidence

INTRODUCTION

Coronavirus disease 2019 (COVID-19), a global pandemic, has infected approximately 10% of the world's population. This comprehensive review aimed to determine the prevalence of various neurological disorders in COVID-19 without overlapping meta-analysis errors.

METHODS

We searched for meta-analyses on neurological disorders following COVID-19 published up to March 14, 2023. We obtained 1,184 studies, of which 44 meta-analyses involving 9,228,588 COVID-19 patients were finally included. After confirming the forest plot of each study and removing overlapping individual studies, a re-meta-analysis was performed using the random-effects model.

RESULTS

The summarized combined prevalence of each neurological disorder is as follows: stroke 3.39% (95% confidence interval, 1.50-5.27), dementia 6.41% (1.36-11.46), multiple sclerosis 4.00% (2.50-5.00), epilepsy 5.36% (-0.60-11.32), Parkinson's disease 0.67% (-1.11-2.45), encephalitis 0.66% (-0.44-1.77), and Guillain-Barré syndrome 3.83% (-0.13-7.80). In addition, the mortality risk of patients with comorbidities of COVID-19 is as follows: stroke OR 1.63 (1.23-2.03), epilepsy OR 1.71 (1.00-2.42), dementia OR 1.90 (1.31-2.48), Parkinson's disease OR 3.94 (-2.12-10.01).

CONCLUSION

Our results show that the prevalence and mortality risk may increase in some neurological diseases during the COVID-19 pandemic. Future studies should elucidate the precise mechanisms for the link between COVID-19 and neurological diseases, determine which patient characteristics predispose them to neurological diseases, and consider potential global patient management.

Children and adolescents' emotional problems during the COVID-19 pandemic in Brazil

Brazil has been severely affected by the COVID-19 pandemic with one of the largest numbers of youth impacted by school closure globally. This longitudinal online survey assessed emotional problems in children and adolescents aged 5-17 years living in Brazil during the COVID-19 pandemic. Recruitment occurred between June to November 2020 and participants were invited for follow-up assessments every 15 days until June 2021. Participants were 5795 children and adolescents living across the country with mean age of 10.7 (SD 3.63) years at recruitment; 50.5% were boys and 69% of white ethnicity. Weighted prevalence rates of anxiety, depressive and total emotional symptoms at baseline were 29.7%, 36.1% and 36%, respectively. Longitudinal analysis included 3221 (55.6%) participants and revealed fluctuations in anxiety and depressive symptoms during one year follow-up, associated with periods of social mobility and mortality. Emotional problems significantly increased in July and September 2020 and decreased from December 2020 to February 2021 and then significantly increased in May 2021 relative to June 2020. Older age, feeling lonely, previous diagnosis of mental or neurodevelopmental disorder, previous exposure to traumatic events or psychological aggression, parental psychopathology, and sleeping less than 8/h a day were associated with increased rates of anxiety and depressive symptoms at baseline and over time. Food insecurity and less social contact with family and peers were associated with baseline anxiety and depressive symptoms, and lowest socio-economic strata, chronic disease requiring treatment and family members physically ill due to COVID-19 were associated with increasing rates over time. The pandemic severely affected youth, particularly those from vulnerable populations and in moments of increased mortality and decreased social mobility. Results underscore the need for allocation of resources to services and the continuous monitoring of mental health problems among children and adolescents.