Carbamazepine (Epilepsy)

Hypospadias

R analysis
id Study   Lib. in paper Exposition period    Study type 
 Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S382
R16394		 Tomson (Carbamazepine), 2018 Hypospadias at least 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 2.15 [0.78;5.92] C 10/1,957   6/2,514 16 1,957
ref
S6290
R16960		 Campbell (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2014 Hypospadias and genitourinary tract defects 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 0.63 [0.22;1.85] C 5/1,657   10/2,098 15 1,657
ref
S5937
R23778		 Hernández-Díaz (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2012 Hypospadias 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No Controls: mixed indications 4.54 [0.18;111.60] C 1/1,033   0/1,562 1 1,033
ref
S5483
R15647		 Bànhidy (Carbamazepine), 2011 Hypospadias throughout pregnancy case control unexposed, sick Adjustment: No Matched 0.33 [0.03;3.78] C 1/11   3/13 4 11
ref
S8411
R26712		 Jentink (Carbamazepine), 2010 Hypospadias 1st trimester case control unexposed (general population or NOS) Adjustment: Yes 0.70 [0.30;1.60] 6/-   -/- - -
ref
S6685
R18587		 D'Souza (Carbamazepine) (Controls unexposed, disease free), 1991 Hypospadias throughout pregnancy prospective cohort unexposed, disease free excluded Adjustment: No Matched 24.60 [0.40;1512.72] C
excluded (control group) 		0/3   0/62 0 3
ref
S6689
R18704		 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 Hypospadias throughout pregnancy prospective cohort unexposed, sick Adjustment: No 3.00 [0.05;194.76] C 0/3   0/8 0 3
ref
S6823
R19301		 Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991 Hypospadias throughout pregnancy prospective cohort unexposed, disease free excluded Adjustment: No Matched 5.19 [0.10;276.47] C
excluded (control group) 		0/11   0/55 0 11
ref
S6825
R19351		 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 Hypospadias throughout pregnancy prospective cohort unexposed, sick Adjustment: No 2.05 [0.04;110.56] C 0/11   0/22 0 11
ref
Total 7 studies 0.97 [0.58;1.64] 36 4,672
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Tomson (Carbamazepine), 2018Tomson, 2018 1 2.15[0.78; 5.92]161,95727%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Campbell (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2014Campbell, 2014 2 0.63[0.22; 1.85]151,65724%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Hernández-Díaz (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2012Hernández-Díaz, 2012 3 4.54[0.18; 111.60]11,0333%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Bànhidy (Carbamazepine), 2011Bànhidy, 2011 4 0.33[0.03; 3.78]4115%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Jentink (Carbamazepine), 2010Jentink, 2010 5 0.70[0.30; 1.60]--39%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA D'Souza (Carbamazepine) (Controls unexposed, sick), 1991D'Souza, 1991 6 3.00[0.05; 194.76]032%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991Van der Pol, 1991 7 2.05[0.04; 110.56]0112%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (7 studies) I2 = 0% 0.97[0.58; 1.64]364,6720.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Carbamazepine; 2: Carbamazepine) (Controls exposed to Lamotrigine, sick; 3: Carbamazepine) (Controls exposed to Lamotrigine, sick; 4: Carbamazepine; 5: Carbamazepine; 6: Carbamazepine) (Controls unexposed, sick; 7: Carbamazepine) (Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.34[0.67; 2.69]324,6610%NATomson (Carbamazepine), 2018 Campbell (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2014 Hernández-Díaz (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2012 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 5 case control studiescase control studies 0.65[0.29; 1.43]4110%NABànhidy (Carbamazepine), 2011 Jentink (Carbamazepine), 2010 2 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.70[0.30; 1.62]-- -NAJentink (Carbamazepine), 2010 1 unexposed, sickunexposed, sick 0.76[0.12; 4.89]4250%NABànhidy (Carbamazepine), 2011 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 3 exposed to other treatment, sickexposed to other treatment, sick 1.34[0.48; 3.71]324,64739%NATomson (Carbamazepine), 2018 Campbell (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2014 Hernández-Díaz (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2012 3 Tags Adjustment   - No  - No 1.21[0.62; 2.36]364,6720%NATomson (Carbamazepine), 2018 Campbell (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2014 Hernández-Díaz (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2012 Bànhidy (Carbamazepine), 2011 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 6   - Yes  - Yes 0.70[0.30; 1.62]-- -NAJentink (Carbamazepine), 2010 1 Controls   - mixed indications  - mixed indications 4.54[0.18; 111.60]11,033 -NAHernández-Díaz (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2012 1 MatchedMatched 0.33[0.03; 3.78]411 -NABànhidy (Carbamazepine), 2011 1 All studiesAll studies 0.97[0.58; 1.64]364,6720%NATomson (Carbamazepine), 2018 Campbell (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2014 Hernández-Díaz (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2012 Bànhidy (Carbamazepine), 2011 Jentink (Carbamazepine), 2010 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 70.110.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-5.05.02.5550.000Tomson (Carbamazepine), 2018Campbell (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2014Hernández-Díaz (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2012Bànhidy (Carbamazepine), 2011Jentink (Carbamazepine), 2010D'Souza (Carbamazepine) (Controls unexposed, sick), 1991Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991

Asymetry test p-value = 0.5332 (by Egger's regression)

slope=-0.3248 (0.5229); intercept=0.4952 (0.7404); t=0.6688; p=0.5332

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6685, 6823

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 2.07[0.25; 17.50]-1444%NAJentink (Carbamazepine), 2010 D'Souza (Carbamazepine) (Controls unexposed, disease free), 1991 Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991 3 unexposed, sick controlsunexposed, sick controls 0.76[0.12; 4.89]4250%NABànhidy (Carbamazepine), 2011 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.34[0.48; 3.71]324,64739%NATomson (Carbamazepine), 2018 Campbell (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2014 Hernández-Díaz (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2012 30.510.01.0