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High-cited favorable studies for COVID-19 treatments ineffective in large trials

OBJECTIVES: To evaluate for coronavirus disease 2019 treatments without benefits in subsequent large randomized controlled trials (RCTs) how many of their most-cited clinical studies had declared favorable results. STUDY DESIGN AND SETTING: Scopus searches (December 23, 2021) identified articles on...

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Autor principal: Ioannidis, John P.A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8986133/
https://www.ncbi.nlm.nih.gov/pubmed/35398190
http://dx.doi.org/10.1016/j.jclinepi.2022.04.001
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author Ioannidis, John P.A.
author_facet Ioannidis, John P.A.
author_sort Ioannidis, John P.A.
collection PubMed
description OBJECTIVES: To evaluate for coronavirus disease 2019 treatments without benefits in subsequent large randomized controlled trials (RCTs) how many of their most-cited clinical studies had declared favorable results. STUDY DESIGN AND SETTING: Scopus searches (December 23, 2021) identified articles on lopinavir-ritonavir, hydroxychloroquine, azithromycin, remdesivir, convalescent plasma, colchicine, or interferon (index interventions) that represented clinical trials and had >150 citations. Their conclusions were correlated with study design features. The 10 most recent citations for the most-cited article on each index intervention were examined on whether they were critical to the highly cited study. Altmetric scores were also obtained. RESULTS: Forty eligible articles of clinical studies had received >150 citations. Twenty of forty (50%) had favorable conclusions and four were equivocal. Highly cited articles with favorable conclusions were rarely RCTs (3/20), although those without favorable conclusions were mostly RCTs (15/20, P = 0.0003). Only one RCT with favorable conclusions had >160 patients. Citation counts correlated strongly with Altmetric scores, especially news items. Only nine (15%) of 60 recent citations to the most highly cited studies with favorable or equivocal conclusions were critical. CONCLUSION: Many clinical studies with favorable conclusions for largely ineffective coronavirus disease 2019 treatments are uncritically heavily cited and disseminated. Early observational studies and small randomized trials may cause spurious claims of effectiveness that get perpetuated.
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spelling pubmed-89861332022-04-07 High-cited favorable studies for COVID-19 treatments ineffective in large trials Ioannidis, John P.A. J Clin Epidemiol Covid-19 Series OBJECTIVES: To evaluate for coronavirus disease 2019 treatments without benefits in subsequent large randomized controlled trials (RCTs) how many of their most-cited clinical studies had declared favorable results. STUDY DESIGN AND SETTING: Scopus searches (December 23, 2021) identified articles on lopinavir-ritonavir, hydroxychloroquine, azithromycin, remdesivir, convalescent plasma, colchicine, or interferon (index interventions) that represented clinical trials and had >150 citations. Their conclusions were correlated with study design features. The 10 most recent citations for the most-cited article on each index intervention were examined on whether they were critical to the highly cited study. Altmetric scores were also obtained. RESULTS: Forty eligible articles of clinical studies had received >150 citations. Twenty of forty (50%) had favorable conclusions and four were equivocal. Highly cited articles with favorable conclusions were rarely RCTs (3/20), although those without favorable conclusions were mostly RCTs (15/20, P = 0.0003). Only one RCT with favorable conclusions had >160 patients. Citation counts correlated strongly with Altmetric scores, especially news items. Only nine (15%) of 60 recent citations to the most highly cited studies with favorable or equivocal conclusions were critical. CONCLUSION: Many clinical studies with favorable conclusions for largely ineffective coronavirus disease 2019 treatments are uncritically heavily cited and disseminated. Early observational studies and small randomized trials may cause spurious claims of effectiveness that get perpetuated. Elsevier Inc. 2022-08 2022-04-06 /pmc/articles/PMC8986133/ /pubmed/35398190 http://dx.doi.org/10.1016/j.jclinepi.2022.04.001 Text en © 2022 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Covid-19 Series
Ioannidis, John P.A.
High-cited favorable studies for COVID-19 treatments ineffective in large trials
title High-cited favorable studies for COVID-19 treatments ineffective in large trials
title_full High-cited favorable studies for COVID-19 treatments ineffective in large trials
title_fullStr High-cited favorable studies for COVID-19 treatments ineffective in large trials
title_full_unstemmed High-cited favorable studies for COVID-19 treatments ineffective in large trials
title_short High-cited favorable studies for COVID-19 treatments ineffective in large trials
title_sort high-cited favorable studies for covid-19 treatments ineffective in large trials
topic Covid-19 Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8986133/
https://www.ncbi.nlm.nih.gov/pubmed/35398190
http://dx.doi.org/10.1016/j.jclinepi.2022.04.001
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