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Analysis of decisions made in meta-analyses of depression screening and the risk of confirmation bias: A case study

BACKGROUND: Depression is common in primary care and clinicians are encouraged to screen their patients. Meta-analyses have evaluated the effectiveness of screening, but two author groups consistently reached completely opposite conclusions. METHODS: We identified five systematic reviews on depressi...

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Autores principales: Goodyear-Smith, Felicity A, van Driel, Mieke L, Arroll, Bruce, Del Mar, Chris
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3464667/
https://www.ncbi.nlm.nih.gov/pubmed/22691262
http://dx.doi.org/10.1186/1471-2288-12-76
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author Goodyear-Smith, Felicity A
van Driel, Mieke L
Arroll, Bruce
Del Mar, Chris
author_facet Goodyear-Smith, Felicity A
van Driel, Mieke L
Arroll, Bruce
Del Mar, Chris
author_sort Goodyear-Smith, Felicity A
collection PubMed
description BACKGROUND: Depression is common in primary care and clinicians are encouraged to screen their patients. Meta-analyses have evaluated the effectiveness of screening, but two author groups consistently reached completely opposite conclusions. METHODS: We identified five systematic reviews on depression screening conducted between 2001 and 2009, three by Gilbody and colleagues and two by the United States Preventive Task Force. The two author groups consistently reached completely opposite conclusions. We analyzed two contemporaneous systematic reviews, applying a stepwise approach to unravel their methods. Decision points were identified, and discrepancies between systematic reviews authors’ justification of choices made were recorded. RESULTS: Two systematic reviews each addressing three research questions included 26 randomized controlled trials with different combinations in each review. For the outcome depression screening resulting in treatment, both reviews undertook meta-analyses of imperfectly overlapping studies. Two in particular, pooled each by only one of the reviews, influenced the recommendations in opposite directions. Justification for inclusion or exclusion of studies was obtuse. CONCLUSION: Systematic reviews may be less objective than assumed. Based on this analysis of two meta-analyses we hypothesise that strongly held prior beliefs (confirmation bias) may have influenced inclusion and exclusion criteria of studies, and their interpretation. Authors should be required to declare a priori any strongly held prior beliefs within their hypotheses, before embarking on systematic reviews.
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spelling pubmed-34646672012-10-05 Analysis of decisions made in meta-analyses of depression screening and the risk of confirmation bias: A case study Goodyear-Smith, Felicity A van Driel, Mieke L Arroll, Bruce Del Mar, Chris BMC Med Res Methodol Research Article BACKGROUND: Depression is common in primary care and clinicians are encouraged to screen their patients. Meta-analyses have evaluated the effectiveness of screening, but two author groups consistently reached completely opposite conclusions. METHODS: We identified five systematic reviews on depression screening conducted between 2001 and 2009, three by Gilbody and colleagues and two by the United States Preventive Task Force. The two author groups consistently reached completely opposite conclusions. We analyzed two contemporaneous systematic reviews, applying a stepwise approach to unravel their methods. Decision points were identified, and discrepancies between systematic reviews authors’ justification of choices made were recorded. RESULTS: Two systematic reviews each addressing three research questions included 26 randomized controlled trials with different combinations in each review. For the outcome depression screening resulting in treatment, both reviews undertook meta-analyses of imperfectly overlapping studies. Two in particular, pooled each by only one of the reviews, influenced the recommendations in opposite directions. Justification for inclusion or exclusion of studies was obtuse. CONCLUSION: Systematic reviews may be less objective than assumed. Based on this analysis of two meta-analyses we hypothesise that strongly held prior beliefs (confirmation bias) may have influenced inclusion and exclusion criteria of studies, and their interpretation. Authors should be required to declare a priori any strongly held prior beliefs within their hypotheses, before embarking on systematic reviews. BioMed Central 2012-06-12 /pmc/articles/PMC3464667/ /pubmed/22691262 http://dx.doi.org/10.1186/1471-2288-12-76 Text en Copyright ©2012 Goodyear-Smith et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Goodyear-Smith, Felicity A
van Driel, Mieke L
Arroll, Bruce
Del Mar, Chris
Analysis of decisions made in meta-analyses of depression screening and the risk of confirmation bias: A case study
title Analysis of decisions made in meta-analyses of depression screening and the risk of confirmation bias: A case study
title_full Analysis of decisions made in meta-analyses of depression screening and the risk of confirmation bias: A case study
title_fullStr Analysis of decisions made in meta-analyses of depression screening and the risk of confirmation bias: A case study
title_full_unstemmed Analysis of decisions made in meta-analyses of depression screening and the risk of confirmation bias: A case study
title_short Analysis of decisions made in meta-analyses of depression screening and the risk of confirmation bias: A case study
title_sort analysis of decisions made in meta-analyses of depression screening and the risk of confirmation bias: a case study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3464667/
https://www.ncbi.nlm.nih.gov/pubmed/22691262
http://dx.doi.org/10.1186/1471-2288-12-76
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