Neglected tropical diseases: survey and geometry of randomised evidence
Identifieur interne : 002862 ( Pmc/Checkpoint ); précédent : 002861; suivant : 002863Neglected tropical diseases: survey and geometry of randomised evidence
Auteurs : Shanthi Kappagoda [États-Unis] ; John P A. IoannidisSource :
- The BMJ [ 0959-8138 ] ; 2012.
Abstract
Url:
DOI: 10.1136/bmj.e6512
PubMed: 23089149
PubMed Central: 3478233
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Neglected tropical diseases: survey and geometry of randomised evidence</title><author><name sortKey="Kappagoda, Shanthi" sort="Kappagoda, Shanthi" uniqKey="Kappagoda S" first="Shanthi" last="Kappagoda">Shanthi Kappagoda</name><affiliation wicri:level="1"><nlm:aff id="aff1">Center for Primary Care and Outcomes Research and Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Primary Care and Outcomes Research and Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA</wicri:regionArea><wicri:noRegion>CA</wicri:noRegion></affiliation></author><author><name sortKey="Ioannidis, John P A" sort="Ioannidis, John P A" uniqKey="Ioannidis J" first="John P A" last="Ioannidis">John P A. Ioannidis</name><affiliation><nlm:aff id="aff2">Stanford Prevention Research Center, Department of Medicine and Department of Health Research and Policy, Stanford University School of Medicine, and Department of Statistics, Stanford University School of Humanities and Sciences, Stanford</nlm:aff><wicri:noCountry code="subfield">Stanford</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23089149</idno><idno type="pmc">3478233</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3478233</idno><idno type="RBID">PMC:3478233</idno><idno type="doi">10.1136/bmj.e6512</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">000721</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000721</idno><idno type="wicri:Area/Pmc/Curation">000721</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000721</idno><idno type="wicri:Area/Pmc/Checkpoint">002862</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002862</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Neglected tropical diseases: survey and geometry of randomised evidence</title><author><name sortKey="Kappagoda, Shanthi" sort="Kappagoda, Shanthi" uniqKey="Kappagoda S" first="Shanthi" last="Kappagoda">Shanthi Kappagoda</name><affiliation wicri:level="1"><nlm:aff id="aff1">Center for Primary Care and Outcomes Research and Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Primary Care and Outcomes Research and Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA</wicri:regionArea><wicri:noRegion>CA</wicri:noRegion></affiliation></author><author><name sortKey="Ioannidis, John P A" sort="Ioannidis, John P A" uniqKey="Ioannidis J" first="John P A" last="Ioannidis">John P A. Ioannidis</name><affiliation><nlm:aff id="aff2">Stanford Prevention Research Center, Department of Medicine and Department of Health Research and Policy, Stanford University School of Medicine, and Department of Statistics, Stanford University School of Humanities and Sciences, Stanford</nlm:aff><wicri:noCountry code="subfield">Stanford</wicri:noCountry></affiliation></author></analytic><series><title level="j">The BMJ</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1756-1833</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold>Objective</bold> To assess the quantity and distribution of evidence from randomised controlled trials for the treatment of the major neglected tropical diseases and to identify gaps in the evidence with network analysis.</p><p><bold>Design</bold> Systematic review and network analysis.</p><p><bold>Data sources</bold> Cochrane Central Register of Controlled Trials and PubMed from inception to 31 August 2011.</p><p><bold>Study selection</bold> Randomised controlled trials that examined treatment of 16 neglected tropical diseases or complications thereof published in English, French, Spanish, Portuguese, German, or Dutch.</p><p><bold>Results</bold> We identified 971 eligible randomised trials. Leishmaniasis (184 trials, 23 039 participants) and geohelminth infections; 160 trials, 46 887 participants) were the most studied, while dracunculiasis (nine trials, 798 participants) and Buruli ulcer (five trials, 337 participants) were least studied. Relative to its global burden of disease, lymphatic filariasis had the fewest trials and participants. Only 11% of trials were industry funded. Either a single trial or trials with fewer than 100 participants comprised the randomised evidence for first or second line treatments for Buruli ulcer, human African trypanosomiasis, American trypanosomiasis, cysticercosis, rabies, echinococcosis, New World cutaneous leishmaniasis, and each of the foodborne trematode infections. Among the 10 disease categories with more than 40 trials, five lacked sufficient head to head comparisons between first or second line treatments.</p><p><bold>Conclusions</bold> There is considerable variation in the amount of evidence from randomised controlled trials for each of the 16 major neglected tropical diseases. Even in diseases with substantial evidence, such as leishmaniasis and geohelminth infections, some recommended treatments have limited supporting data and lack head to head comparisons.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMJ</journal-id><journal-id journal-id-type="iso-abbrev">BMJ</journal-id><journal-id journal-id-type="publisher-id">bmj</journal-id><journal-title-group><journal-title>The BMJ</journal-title></journal-title-group><issn pub-type="ppub">0959-8138</issn><issn pub-type="epub">1756-1833</issn><publisher><publisher-name>BMJ Publishing Group Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23089149</article-id><article-id pub-id-type="pmc">3478233</article-id><article-id pub-id-type="publisher-id">kaps006312</article-id><article-id pub-id-type="doi">10.1136/bmj.e6512</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group><subj-group subj-group-type="hw-coll-titles"><subject>Infectious Diseases</subject><subject>Immunology (Including Allergy)</subject><subject>Dermatology</subject><subject>Internet</subject></subj-group></article-categories><title-group><article-title>Neglected tropical diseases: survey and geometry of randomised evidence</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kappagoda</surname><given-names>Shanthi</given-names></name><role>fellow</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Ioannidis</surname><given-names>John P A</given-names></name><role>professor</role><xref ref-type="aff" rid="aff2">2</xref></contrib><aff id="aff1"><label>1</label>Center for Primary Care and Outcomes Research and Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA</aff><aff id="aff2"><label>2</label>Stanford Prevention Research Center, Department of Medicine and Department of Health Research and Policy, Stanford University School of Medicine, and Department of Statistics, Stanford University School of Humanities and Sciences, Stanford</aff></contrib-group><author-notes><corresp>Correspondence to: J P A Ioannidis, Stanford Prevention Research Center, 1265 Welch Road, MSOB X306, Stanford, CA 94305-5411, USA <email>jioannid@stanford.edu</email></corresp></author-notes><pub-date pub-type="collection"><year>2012</year></pub-date><pub-date pub-type="epub"><day>22</day><month>10</month><year>2012</year></pub-date><volume>345</volume><elocation-id>e6512</elocation-id><history><date date-type="accepted"><day>18</day><month>9</month><year>2012</year></date></history><permissions><copyright-statement>© Kappagoda et al 2012</copyright-statement><copyright-year>2012</copyright-year><copyright-holder>Kappagoda et al</copyright-holder><license license-type="open-access"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/">http://creativecommons.org/licenses/by-nc/2.0/</ext-link> and <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/legalcode">http://creativecommons.org/licenses/by-nc/2.0/legalcode</ext-link>.</license-p></license></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="bmj.e6512.pdf"></self-uri><abstract><p><bold>Objective</bold> To assess the quantity and distribution of evidence from randomised controlled trials for the treatment of the major neglected tropical diseases and to identify gaps in the evidence with network analysis.</p><p><bold>Design</bold> Systematic review and network analysis.</p><p><bold>Data sources</bold> Cochrane Central Register of Controlled Trials and PubMed from inception to 31 August 2011.</p><p><bold>Study selection</bold> Randomised controlled trials that examined treatment of 16 neglected tropical diseases or complications thereof published in English, French, Spanish, Portuguese, German, or Dutch.</p><p><bold>Results</bold> We identified 971 eligible randomised trials. Leishmaniasis (184 trials, 23 039 participants) and geohelminth infections; 160 trials, 46 887 participants) were the most studied, while dracunculiasis (nine trials, 798 participants) and Buruli ulcer (five trials, 337 participants) were least studied. Relative to its global burden of disease, lymphatic filariasis had the fewest trials and participants. Only 11% of trials were industry funded. Either a single trial or trials with fewer than 100 participants comprised the randomised evidence for first or second line treatments for Buruli ulcer, human African trypanosomiasis, American trypanosomiasis, cysticercosis, rabies, echinococcosis, New World cutaneous leishmaniasis, and each of the foodborne trematode infections. Among the 10 disease categories with more than 40 trials, five lacked sufficient head to head comparisons between first or second line treatments.</p><p><bold>Conclusions</bold> There is considerable variation in the amount of evidence from randomised controlled trials for each of the 16 major neglected tropical diseases. Even in diseases with substantial evidence, such as leishmaniasis and geohelminth infections, some recommended treatments have limited supporting data and lack head to head comparisons.</p></abstract></article-meta><notes notes-type="data-supplement"><label>Web Extra</label><title>Extra material supplied by the author</title><supplementary-material content-type="local-data"><caption><p>Appendix: Supplementary figures and tables</p></caption><media xlink:href="kaps006312.ww1_default.pdf"><caption><p>Click here for additional data file.</p></caption></media></supplementary-material></notes></front></pmc><affiliations><list><country><li>États-Unis</li></country></list><tree><noCountry><name sortKey="Ioannidis, John P A" sort="Ioannidis, John P A" uniqKey="Ioannidis J" first="John P A" last="Ioannidis">John P A. Ioannidis</name></noCountry><country name="États-Unis"><noRegion><name sortKey="Kappagoda, Shanthi" sort="Kappagoda, Shanthi" uniqKey="Kappagoda S" first="Shanthi" last="Kappagoda">Shanthi Kappagoda</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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