| Ref ID | 1001 |
| First Author | L. Cosgrove |
| Journal | ACCOUNTABILITY IN RESEARCH |
| Year Of Publishing | 2024 |
| URL | https://www.tandfonline.com/doi/full/10.1080/08989621.2022.2082289 |
| Keywords |
• Harms • Mental health • Outcomes • Risk of bias |
| Problem(s) |
• Financial conflicts of interest of review authors • Limited quality assessment or no risk of bias • Failure to define clinically meaningful outcomes • Inclusion of observational / non-randomised studies • Meta-analyses and forest plots presented without considering risk of bias / quality • Selective reporting of harms / safety / adverse events / side effects |
| Article Type | Editorial |
| Article Subtype | Discussion piece |
| First Author Country | United States |
| Aim | The authors use a recent systematic review of long-acting injectable antipsychotics (LAIs) vs oral antipsychotics for schizophrenia to illustrate some design problems, and how commercial interests can influence the evidence syntheses, and conclusions. |
| Level of Investigation | Descriptive |
| Summary of Findings | In a discussion piece, the authors drew attention to the fact that the authors of a recently published systematic review had financial associations with the manufacturers of long-acting injectable antipsychotics (LAIs) which concluded that LAIs “provided significant benefit” compared to oral antipsychotics. They highlight 4 decisions and describe how they could lead to an overestimate of benefit and an underestimation of harms. The decisions were: 1) The inclusion of pre-post and cohort studies and a lack of discussion of how this level of evidence might affect the overall results. 2) A misrepresentation of the profile of adverse events in the body of the paper compared to the data provided in the appendix, which showed that oral administration was less harmful. 3) Failure to account for poorly conducted studies such as performing a sensitivity analysis to exclude studies with a high risk of bias. 4) The outcomes measured were symptoms and hospitalizations, but not other patient oriented outcomes such as Quality of Life and recovery. |
| Number of systematic reviews included | 1 |
| Number of eligible systematic reviews assessed | 1 |