Concerns Regarding Strength of Conclusions in Systematic Review and Meta-Analysis of Neuroradiological Abnormalities in First-Episode Psychosis

Ref ID 1008
First Author B. Dralle
Journal JAMA PSYCHIATRY
Year Of Publishing 2024
URL https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2811489
Keywords • Diagnostic
• Expertise
• Mental health
Problem(s) • Failure to define clinically meaningful outcomes
• Spin or subjective interpretation of findings
Article Type Editorial
Article Subtype Comment/letter
First Author Country United States
Aim To highlight 3 points regarding the strength of conclusions in a systematic review and meta-analysis published in 2023 regarding neuroradiological abnormalities in first-episode of psychosis.
Level of Investigation Descriptive
Summary of Findings From a letter to the editor concerning a systematic review and meta-analysis published in 2023 regarding neuroradiological abnormalities in first-episode of psychosis. The letter authors found 3 points of concern in the strength of the conclusions: 1) The definition of “clinical relevance” is unclear, particularly when applied to white matter abnormalities. 2) The authors overemphasise conclusions from the leave-one-out sensitivity analysis regarding the relative risk of clinically relevant abnormalities in patients with FEP vs controls. 3) The opportunity cost associated with MRI is not adequately addressed. Although the authors note the cost to detect 1 abnormality in Europe is approximately $4752, and in the US, it is higher (approximately $23 400), the potential benefits of alternative allocations such as medication, housing, food, and vocational rehabilitation, according to the authors, must also be considered.
Number of systematic reviews included 1
Number of eligible systematic reviews assessed 1
Treatment impacted No
Treatment impacted description
Interpretation impacted Not Applicable
Interpretation impacted description