The problem of subgroup analyses: an example from a trial on ruptured intracranial aneurysms.

The randomized ISAT demonstrated the superiority of endovascular treatment in patients with ruptured intracranial aneurysms considered suitable for either clipping or coiling. A later publication proposed a second look at the results, demonstrating that older patients with ruptured MCA aneurysms app...

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Main Authors: Naggara, O, Raymond, J, Guilbert, F, Altman, D
Format: Journal article
Language:English
Published: 2011
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author Naggara, O
Raymond, J
Guilbert, F
Altman, D
author_facet Naggara, O
Raymond, J
Guilbert, F
Altman, D
author_sort Naggara, O
collection OXFORD
description The randomized ISAT demonstrated the superiority of endovascular treatment in patients with ruptured intracranial aneurysms considered suitable for either clipping or coiling. A later publication proposed a second look at the results, demonstrating that older patients with ruptured MCA aneurysms appeared to benefit from clipping, in disagreement with the general findings of the trial. Subgroup analyses in randomized trials and observational studies examine whether effects of interventions differ between subgroups according to the characteristics of patients. However, many apparent subgroup effects have been shown to be spurious. Misleading subgroup effects can result in withholding efficacious treatment from patients who would benefit or can encourage ineffective or potentially harmful treatments for patients who would fare better without. Some guidelines for the prudent interpretation of subgroup findings are reviewed.
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spelling oxford-uuid:dbbbdf69-db8e-4c45-a8d6-b29d3c6dfb552022-03-27T09:12:39ZThe problem of subgroup analyses: an example from a trial on ruptured intracranial aneurysms.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:dbbbdf69-db8e-4c45-a8d6-b29d3c6dfb55EnglishSymplectic Elements at Oxford2011Naggara, ORaymond, JGuilbert, FAltman, DThe randomized ISAT demonstrated the superiority of endovascular treatment in patients with ruptured intracranial aneurysms considered suitable for either clipping or coiling. A later publication proposed a second look at the results, demonstrating that older patients with ruptured MCA aneurysms appeared to benefit from clipping, in disagreement with the general findings of the trial. Subgroup analyses in randomized trials and observational studies examine whether effects of interventions differ between subgroups according to the characteristics of patients. However, many apparent subgroup effects have been shown to be spurious. Misleading subgroup effects can result in withholding efficacious treatment from patients who would benefit or can encourage ineffective or potentially harmful treatments for patients who would fare better without. Some guidelines for the prudent interpretation of subgroup findings are reviewed.
spellingShingle Naggara, O
Raymond, J
Guilbert, F
Altman, D
The problem of subgroup analyses: an example from a trial on ruptured intracranial aneurysms.
title The problem of subgroup analyses: an example from a trial on ruptured intracranial aneurysms.
title_full The problem of subgroup analyses: an example from a trial on ruptured intracranial aneurysms.
title_fullStr The problem of subgroup analyses: an example from a trial on ruptured intracranial aneurysms.
title_full_unstemmed The problem of subgroup analyses: an example from a trial on ruptured intracranial aneurysms.
title_short The problem of subgroup analyses: an example from a trial on ruptured intracranial aneurysms.
title_sort problem of subgroup analyses an example from a trial on ruptured intracranial aneurysms
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