Phenobarbital (Epilepsy)

Congenital heart defects

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.
S12834
R48344
Thomas (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2021 Cardiac malformations 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 2.24 [0.26;19.12] C
excluded (control group)
6/137   1/50 7 137
ref
S12835
R48354
Thomas (Phenobarbital) (Controls unexposed, sick), 2021 Cardiac malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 1.68 [0.59;4.83] C 6/137   9/340 15 137
ref
S7660
R22659
Tomson (Phenobarbital), 2018 Cardiac malformations at least 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 4.66 [1.96;11.09] C 8/294   15/2,514 23 294
ref
S5941
R23805
Hernández-Díaz (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2012 Cardiovascular anomalies 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No Controls: mixed indications 13.39 [3.18;56.48] C 5/199   3/1,562 8 199
ref
S6500
R17854
Bànhidy (Phenobarbital), 2011 Cardiovascular congenital abnormalities throughout pregnancy case control unexposed, sick Adjustment: No Matched 2.11 [0.04;124.53] C 0/   5/15 5 0
ref
S6686
R18613
D'Souza (Phenobarbital) (Controls unexposed, disease free), 1991 Heart disease throughout pregnancy prospective cohort unexposed, disease free excluded Adjustment: No Matched 73.80 [2.36;2304.87] C
excluded (control group)
1/4   0/62 1 4
ref
S6694
R18774
D'Souza (Phenobarbital) (Controls unexposed, sick), 1991 Heart disease throughout pregnancy prospective cohort unexposed, sick Adjustment: No 2.33 [0.11;50.99] C 1/4   1/8 2 4
ref
S5526
R19274
Van der Pol (Phenobarbital) (Controls unexposed, disease free), 1991 Cardiac anomaly throughout pregnancy prospective cohort unexposed, disease free excluded Adjustment: No Matched 1.55 [0.06;40.54] C
excluded (control group)
0/12   1/55 1 12
ref
S6824
R19324
Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991 Cardiac anomaly throughout pregnancy prospective cohort unexposed, sick Adjustment: No 1.87 [0.03;100.54] C 0/12   0/22 0 12
ref
Total 6 studies 3.84 [1.95;7.54] 53 646
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 Thomas (Phenobarbital) (Controls unexposed, sick), 2021Thomas, 2021 1 1.68[0.59; 4.83]1513731%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Tomson (Phenobarbital), 2018Tomson, 2018 2 4.66[1.96; 11.09]2329440%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Hernández-Díaz (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2012Hernández-Díaz, 2012 3 13.39[3.18; 56.48]819919%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Bànhidy (Phenobarbital), 2011Bànhidy, 2011 4 2.11[0.04; 124.53]5-3%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate D'Souza (Phenobarbital) (Controls unexposed, sick), 1991D'Souza, 1991 5 2.33[0.11; 50.99]245%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991Van der Pol, 1991 6 1.87[0.03; 100.54]0123%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (6 studies) I2 = 13% 3.84[1.95; 7.54]536460.550.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 3.93[1.79; 8.63]4864629%NAThomas (Phenobarbital) (Controls unexposed, sick), 2021 Tomson (Phenobarbital), 2018 Hernández-Díaz (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2012 D'Souza (Phenobarbital) (Controls unexposed, sick), 1991 Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991 5 case control studiescase control studies 2.11[0.04; 124.53]5- -NABànhidy (Phenobarbital), 2011 1 Type of controls unexposed, sickunexposed, sick 1.77[0.69; 4.53]221530%NAThomas (Phenobarbital) (Controls unexposed, sick), 2021 Bànhidy (Phenobarbital), 2011 D'Souza (Phenobarbital) (Controls unexposed, sick), 1991 Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991 4 exposed to other treatment, sickexposed to other treatment, sick 6.71[2.51; 17.96]3149334%NATomson (Phenobarbital), 2018 Hernández-Díaz (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2012 2 Tags Adjustment   - No  - No 3.84[1.95; 7.54]5364613%NAThomas (Phenobarbital) (Controls unexposed, sick), 2021 Tomson (Phenobarbital), 2018 Hernández-Díaz (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2012 Bànhidy (Phenobarbital), 2011 D'Souza (Phenobarbital) (Controls unexposed, sick), 1991 Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991 6 Controls   - mixed indications  - mixed indications 13.39[3.18; 56.48]8199 -NAHernández-Díaz (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2012 1 MatchedMatched 2.11[0.04; 124.53]5- -NABànhidy (Phenobarbital), 2011 1 All studiesAll studies 3.84[1.95; 7.54]5364613%NAThomas (Phenobarbital) (Controls unexposed, sick), 2021 Tomson (Phenobarbital), 2018 Hernández-Díaz (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2012 Bànhidy (Phenobarbital), 2011 D'Souza (Phenobarbital) (Controls unexposed, sick), 1991 Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991 60.550.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.96.22.4960.000Thomas (Phenobarbital) (Controls unexposed, sick), 2021Tomson (Phenobarbital), 2018Hernández-Díaz (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2012Bànhidy (Phenobarbital), 2011D'Souza (Phenobarbital) (Controls unexposed, sick), 1991Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991

Asymetry test p-value = 0.8431 (by Egger's regression)

slope=1.4666 (0.6969); intercept=-0.2020 (0.9569); t=0.2111; p=0.8431

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6686, 5526, 12834

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) Out of scale10.28[0.23; 452.32]21661%NAD'Souza (Phenobarbital) (Controls unexposed, disease free), 1991 Van der Pol (Phenobarbital) (Controls unexposed, disease free), 1991 2 unexposed, sick controlsunexposed, sick controls 1.77[0.69; 4.53]221530%NAThomas (Phenobarbital) (Controls unexposed, sick), 2021 Bànhidy (Phenobarbital), 2011 D'Souza (Phenobarbital) (Controls unexposed, sick), 1991 Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991 4 exposed to other treatment, sick controlsexposed to other treatment, sick controls 5.62[2.55; 12.37]3863012%NAThomas (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2021 Tomson (Phenobarbital), 2018 Hernández-Díaz (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2012 30.510.01.0