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Titolo:
The influence of a dominating centre on a quantitative systematic review of granisetron for preventing postoperative nausea and vomiting
Autore:
Kranke, P; Apfel, CC; Eberhart, LH; Georgieff, M; Roewer, N;
Indirizzi:
Univ Wuerzburg, Dept Anaesthesiol, D-97080 Wuerzburg, Germany Univ Wuerzburg Wuerzburg Germany D-97080 iol, D-97080 Wuerzburg, Germany Univ Ulm, Dept Anaesthesiol, D-89069 Ulm, Germany Univ Ulm Ulm Germany D-89069 lm, Dept Anaesthesiol, D-89069 Ulm, Germany
Titolo Testata:
ACTA ANAESTHESIOLOGICA SCANDINAVICA
fascicolo: 6, volume: 45, anno: 2001,
pagine: 659 - 670
SICI:
0001-5172(200107)45:6<659:TIOADC>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
PROPHYLACTIC ANTIEMETIC THERAPY; PREOPERATIVE ORAL GRANISETRON; MIDDLE-EAR SURGERY; LAPAROSCOPIC CHOLECYSTECTOMY; BREAST SURGERY; DOUBLE-BLIND; STRABISMUS SURGERY; MOTION SICKNESS; DEXAMETHASONE COMBINATION; CONTROLLED TRIALS;
Keywords:
meta-analysis; quantitative systematic review; post-operative nausea and vomiting (PONV); publication bias; granisetron;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
53
Recensione:
Indirizzi per estratti:
Indirizzo: Apfel, CC Univ Wuerzburg, Dept Anaesthesiol, Josef Schneider Str 2, D-97080 Wuerzburg, Germany Univ Wuerzburg Josef Schneider Str 2 Wuerzburg Germany D-97080
Citazione:
P. Kranke et al., "The influence of a dominating centre on a quantitative systematic review of granisetron for preventing postoperative nausea and vomiting", ACT ANAE SC, 45(6), 2001, pp. 659-670

Abstract

Background: We performed a meta-analysis on granisetron in the prevention of postoperative nausea and vomiting (PONV) and further investigated whether total results and the dose-response characteristics may be significantly affected by a single centre. Methods: Systematically searched randomised controlled trials (RCT) using granisetron for the prevention of PONV after general anaesthesia were included in the analysis. The pooled relative risks (RR) and numbers needed to treat (NNT) with their corresponding 95%-confidence intervals C(I) were calculated. For all centres, one dominating centre and other centres pooled, comparisons were performed according to all doses, low dose (less than or equal to 20 mug/kg) and high dose (> 20 mug/kg) granisetron. Results: A total of 27 RCT with 2938 patients were included in the analysis. RR (CI) to suffer from PONV with granisetron when all comparisons were considered was 0.46 (0.39-0.54), 0.7 (0.6-0.81) and 0.34 (0.28-0.41) for alldoses, low and high dose, respectively RR of the dominating centre (1867 patients) were significantly better compared to the remaining centres (1071 patients), with 0.41 (0.34-0.49) and 0.60 (0.49-0.73), respectively. In thedominating centre low dose granisetron was ineffective with a RR of 0.84 (0.68-1.04), while high dose granisetron led to a strong decrease with a RR of 0.30 (0.26-0.36). In contrast, the RR of other centres pooled for low and high dose granisetron were comparable with 0.62 (0.49-0.79) and 0.56 (0.42-0.75), respectively. Conclusions: Overall results and dose-response characteristics of meta-analyses may be significantly altered by one dominating centre. Further, if data of a dominating centre do not appear to be valid for other centres, it may seem advisable to either exclude them from the analysis or to perform sub-group analyses so that results without the data from the dominating centre are available.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/09/20 alle ore 23:26:48