Carbamazepine (Epilepsy)

ASD (Autism spectrum disorder): Diagnosis/Risk

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.
S15868
R65362		 Dreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Autism spectrum disorder - Corresponding ICD-10 F-chapter - Up to 22 years of age during pregnancy (anytime or not specified) population based cohort propective exposed to other treatment, sick excluded Adjustment: No 1.31 [0.88;1.93] C
excluded (control group) 		42/2,665   64/5,288 106 2,665
ref
S15869
R65378		 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Autism spectrum disorder - Corresponding ICD-10 F-chapter - Up to 22 years of age during pregnancy (anytime or not specified) population based cohort propective unexposed, sick Adjustment: Yes 1.03 [0.70;1.51] 42/2,665   323/22,203 365 2,665
ref
S10075
R46619		 Coste (Carbamazepine), 2020 Diagnosis Pervasive developmental disorders (F84) (mean age of 3.7 years old) during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick Adjustment: No 0.80 [0.05;14.03] C 0/176   7/2,108 7 176
ref
S8024
R46621		 Wiggs (Carbamazepine), 2020 Austism Spectrum Disorder (after 2 years of age) at least 1st trimester population based cohort retrospective unexposed, sick Adjustment: Yes 1.26 [0.88;1.79] -/-   -/11,298 - -
ref
S7510
R46620		 Huber-Mollema (Carbamazepine), 2019 Diagnosis of autism spectrum disorder throughout pregnancy prospective cohort exposed to other treatment, sick Adjustment: No 1.20 [0.21;6.85] C 2/37   4/88 6 37
ref
S9978
R46623		 Bjørk (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2018 Autistic traits at 18 months and/or at 36 months (M-CHAT <2/6 critical or <3/23 or SCQ >13) during pregnancy (anytime or not specified) population based cohort propective exposed to other treatment, sick excluded Adjustment: No 0.83 [0.29;2.38] C
excluded (control group) 		6/41   13/76 19 41
ref
S9979
R46624		 Bjørk (Carbamazepine) (Controls unexposed, disease free), 2018 Autistic traits at 18 months and/or at 36 months (M-CHAT <2/6 critical or <3/23 or SCQ >13) during pregnancy (anytime or not specified) population based cohort propective unexposed, disease free excluded Adjustment: No 1.70 [0.72;4.05] C
excluded (control group) 		6/41   6,907/75,497 6,913 41
ref
S9980
R46625		 Bjørk (Carbamazepine) (Controls unexposed, sick), 2018 Autistic traits at 18 months and/or at 36 months (M-CHAT <2/6 critical or <3/23 or SCQ >13) during pregnancy (anytime or not specified) population based cohort propective unexposed, sick Adjustment: No 1.56 [0.60;4.03] C 6/41   27/272 33 41
ref
S6181
R46622		 Wood (Carbamazepine), 2015 Score >30 (CARS) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 0.78 [0.03;21.03] C 1/34   0/9 1 34
ref
S6661
R46616		 Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Autistic Spectrum Disorders (at 6 years old) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.19 [0.01;4.87] C
excluded (control group) 		0/50   1/30 1 50
ref
S6660
R46617		 Bromley (Carbamazepine) (Controls unexposed, disease free), 2013 Autistic Spectrum Disorders (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: No 0.47 [0.02;8.88] C
excluded (control group) 		0/50   4/214 4 50
ref
S5486
R46618		 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Autistic Spectrum Disorders (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.52 [0.01;26.73] C 0/50   0/26 0 50
ref
Total 7 studies 1.16 [0.91;1.49] 412 3,003
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 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Dreier, 2023 1 1.03[0.70; 1.51]3652,66541%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Coste (Carbamazepine), 2020Coste, 2020 2 0.80[0.05; 14.03]71761%ROB confusion: moderateROB selection: moderateROB classification: criticalROB missing: moderateROB mesure: criticalROB reporting: moderate Wiggs (Carbamazepine), 2020Wiggs, 2020 3 1.26[0.88; 1.79]--48%ROB confusion: seriousROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Huber-Mollema (Carbamazepine), 2019Huber-Mollema, 2019 4 1.20[0.21; 6.85]6372%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Bjørk (Carbamazepine) (Controls unexposed, sick), 2018Bjørk, 2018 5 1.56[0.60; 4.03]33417%ROB confusion: unclearROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Wood (Carbamazepine), 2015Wood, 2015 6 0.78[0.03; 21.03]1341%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: criticalROB mesure: lowROB reporting: moderate Bromley (Carbamazepine) (Controls unexposed, sick), 2013Bromley, 2013 7 0.52[0.01; 26.73]0500%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Total (7 studies) I2 = 0% 1.16[0.91; 1.49]4123,0030.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.16[0.91; 1.49]4123,0030%NADreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Coste (Carbamazepine), 2020 Wiggs (Carbamazepine), 2020 Huber-Mollema (Carbamazepine), 2019 Bjørk (Carbamazepine) (Controls unexposed, sick), 2018 Wood (Carbamazepine), 2015 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 7 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.17[0.91; 1.50]3982,7560%NADreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Wiggs (Carbamazepine), 2020 Bjørk (Carbamazepine) (Controls unexposed, sick), 2018 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 4 exposed to other treatment, sickexposed to other treatment, sick 1.02[0.26; 3.96]142470%NACoste (Carbamazepine), 2020 Huber-Mollema (Carbamazepine), 2019 Wood (Carbamazepine), 2015 3 Tags Adjustment   - No  - No 1.30[0.61; 2.80]473380%NACoste (Carbamazepine), 2020 Huber-Mollema (Carbamazepine), 2019 Bjørk (Carbamazepine) (Controls unexposed, sick), 2018 Wood (Carbamazepine), 2015 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 5   - Yes  - Yes 1.15[0.88; 1.49]3652,6650%NADreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Wiggs (Carbamazepine), 2020 2 All studiesAll studies 1.16[0.91; 1.49]4123,0030%NADreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Coste (Carbamazepine), 2020 Wiggs (Carbamazepine), 2020 Huber-Mollema (Carbamazepine), 2019 Bjørk (Carbamazepine) (Controls unexposed, sick), 2018 Wood (Carbamazepine), 2015 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 70.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.74.92.4180.000Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Coste (Carbamazepine), 2020Wiggs (Carbamazepine), 2020Huber-Mollema (Carbamazepine), 2019Bjørk (Carbamazepine) (Controls unexposed, sick), 2018Wood (Carbamazepine), 2015Bromley (Carbamazepine) (Controls unexposed, sick), 2013

Asymetry test p-value = 0.6216 (by Egger's regression)

slope=0.1868 (0.0904); intercept=-0.1425 (0.2712); t=0.5256; p=0.6216

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6661, 6660, 9978, 9979, 15868

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.54[0.67; 3.53]6,917910%NABjørk (Carbamazepine) (Controls unexposed, disease free), 2018 Bromley (Carbamazepine) (Controls unexposed, disease free), 2013 2 unexposed, sick controlsunexposed, sick controls 1.17[0.91; 1.50]3982,7560%NADreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Wiggs (Carbamazepine), 2020 Bjørk (Carbamazepine) (Controls unexposed, sick), 2018 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 4 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.19[0.84; 1.70]1403,0030%NADreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Coste (Carbamazepine), 2020 Huber-Mollema (Carbamazepine), 2019 Bjørk (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2018 Wood (Carbamazepine), 2015 Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 60.510.01.0