A Practical Approach in Refining Binary Outcome for Treatment Effect of COVID-19 According to Geographical Diversity

The recent COVID-19 pandemic has drawn attention to health and economics worldwide. Initially, diseases only ravage local populations, while a pandemic could aggravate global economic burdens. Lopinavir/Ritonavir is an anti-HIV drug that was used on small scale patients during SARS, but its effectiv...

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Main Author: I-Shiang Tzeng
Format: Article
Language:English
Published: MDPI AG 2023-01-01
Series:Tropical Medicine and Infectious Disease
Subjects:
Online Access:https://www.mdpi.com/2414-6366/8/2/83
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author I-Shiang Tzeng
author_facet I-Shiang Tzeng
author_sort I-Shiang Tzeng
collection DOAJ
description The recent COVID-19 pandemic has drawn attention to health and economics worldwide. Initially, diseases only ravage local populations, while a pandemic could aggravate global economic burdens. Lopinavir/Ritonavir is an anti-HIV drug that was used on small scale patients during SARS, but its effectiveness for COVID-19 treatment is still unclear. Previous studies or meta-analysis have retrieved clinical data of subgroup analysis to evaluate the efficacy and safety of Lopinavir/Ritonavir for the treatment of COVID-19 in a few affected regions. However, geographical diversity and small number of studies bias correction were not achieved in such subgroup analysis of published meta-analysis. The present study demonstrates a practical approach in refining the binary outcome for COVID-19 treatment of Lopinavir/Ritonavir according to geographical location diversity and small number of studies (less than or equal to five) for subgroup analysis. After performing practical approach, the risk of adverse event with LPV/RTV for treatment of COVID-19 becomes nonsignificant compared to previous meta-analysis. Furthermore, we also notice heterogeneity of random effect of meta-analysis may be declined after proposed adjustment. In conclusion, proposed practical approach is recommend for performing a subgroup analysis to avoid concentration in a single geographical location and small number of studies bias.
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spelling doaj.art-6ebaff1301ae4275830d0ec45dc32d382023-11-16T23:39:41ZengMDPI AGTropical Medicine and Infectious Disease2414-63662023-01-01828310.3390/tropicalmed8020083A Practical Approach in Refining Binary Outcome for Treatment Effect of COVID-19 According to Geographical DiversityI-Shiang Tzeng0Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, TaiwanThe recent COVID-19 pandemic has drawn attention to health and economics worldwide. Initially, diseases only ravage local populations, while a pandemic could aggravate global economic burdens. Lopinavir/Ritonavir is an anti-HIV drug that was used on small scale patients during SARS, but its effectiveness for COVID-19 treatment is still unclear. Previous studies or meta-analysis have retrieved clinical data of subgroup analysis to evaluate the efficacy and safety of Lopinavir/Ritonavir for the treatment of COVID-19 in a few affected regions. However, geographical diversity and small number of studies bias correction were not achieved in such subgroup analysis of published meta-analysis. The present study demonstrates a practical approach in refining the binary outcome for COVID-19 treatment of Lopinavir/Ritonavir according to geographical location diversity and small number of studies (less than or equal to five) for subgroup analysis. After performing practical approach, the risk of adverse event with LPV/RTV for treatment of COVID-19 becomes nonsignificant compared to previous meta-analysis. Furthermore, we also notice heterogeneity of random effect of meta-analysis may be declined after proposed adjustment. In conclusion, proposed practical approach is recommend for performing a subgroup analysis to avoid concentration in a single geographical location and small number of studies bias.https://www.mdpi.com/2414-6366/8/2/83COVID-19efficacysafetyLopinavir/Ritonavirsmall number of studies biasgeographical diversity
spellingShingle I-Shiang Tzeng
A Practical Approach in Refining Binary Outcome for Treatment Effect of COVID-19 According to Geographical Diversity
Tropical Medicine and Infectious Disease
COVID-19
efficacy
safety
Lopinavir/Ritonavir
small number of studies bias
geographical diversity
title A Practical Approach in Refining Binary Outcome for Treatment Effect of COVID-19 According to Geographical Diversity
title_full A Practical Approach in Refining Binary Outcome for Treatment Effect of COVID-19 According to Geographical Diversity
title_fullStr A Practical Approach in Refining Binary Outcome for Treatment Effect of COVID-19 According to Geographical Diversity
title_full_unstemmed A Practical Approach in Refining Binary Outcome for Treatment Effect of COVID-19 According to Geographical Diversity
title_short A Practical Approach in Refining Binary Outcome for Treatment Effect of COVID-19 According to Geographical Diversity
title_sort practical approach in refining binary outcome for treatment effect of covid 19 according to geographical diversity
topic COVID-19
efficacy
safety
Lopinavir/Ritonavir
small number of studies bias
geographical diversity
url https://www.mdpi.com/2414-6366/8/2/83
work_keys_str_mv AT ishiangtzeng apracticalapproachinrefiningbinaryoutcomefortreatmenteffectofcovid19accordingtogeographicaldiversity
AT ishiangtzeng practicalapproachinrefiningbinaryoutcomefortreatmenteffectofcovid19accordingtogeographicaldiversity