Phenobarbital (All indications)

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.
S12782
R48792
Bjørk (Phenobarbital) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2022 Diagnosis of childhood autism (F84.0), atypical autism (F84.1), and Asperger syndrome (F84.5) (between 6.1 and 7.9 years old) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 2.82 [1.13;7.05] C
excluded (control group)
5/175   82/7,950 87 175
ref
S12785
R48793
Bjørk (Phenobarbital) (Controls unexposed NOS) (Mixed indications), 2022 Diagnosis of childhood autism (F84.0), atypical autism (F84.1), and Asperger syndrome (F84.5) (between 6.1 and 7.9 years old) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: Yes 1.40 [0.58;3.37]
excluded (control group)
5/175   38,437/4,463,879 38,442 175
ref
S12788
R48794
Bjørk (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2022 Diagnosis of childhood autism (F84.0), atypical autism (F84.1), and Asperger syndrome (F84.5) (between 6.1 and 7.9 years old) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: No Controls: epilepsy indication 2.35 [0.96;5.77] C 5/175   267/21,634 272 175
ref
S9160
R48795
Coste (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2020 Diagnosis Pervasive developmental disorders (F84) (mean age of 3.6 years old) during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Controls: mixed indications 1.60 [0.09;27.50] C
excluded (control group)
0/84   10/2,813 10 84
ref
S9161
R48796
Coste (Phenobarbital) (Controls unexposed, NOS), 2020 Diagnosis Pervasive developmental disorders (F84) (mean age of 3.6 years old) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 2.39 [0.15;38.48] C 0/84   4,280/1,710,441 4,280 84
ref
Total 2 studies 2.36 [1.00;5.54] 4,552 259
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 Bjørk (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2022Bjørk, 2022 1 2.35[0.96; 5.77]27217591%ROB confusion: unclearROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Coste (Phenobarbital) (Controls unexposed, NOS), 2020Coste, 2020 2 2.39[0.15; 38.48]4,280849%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (2 studies) I2 = 0% 2.36[1.00; 5.54]4,5522590.95.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Phenobarbital) (Controls unexposed, sick) (Mixed indications; 2: Phenobarbital) (Controls unexposed, NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 2.36[1.00; 5.54]4,5522590%NABjørk (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2022 Coste (Phenobarbital) (Controls unexposed, NOS), 2020 2 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 2.39[0.15; 38.48]4,28084 -NACoste (Phenobarbital) (Controls unexposed, NOS), 2020 1 unexposed, sickunexposed, sick 2.35[0.96; 5.77]272175 -NABjørk (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2022 1 Tags Adjustment   - No  - No 2.36[1.00; 5.54]4,5522590%NABjørk (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2022 Coste (Phenobarbital) (Controls unexposed, NOS), 2020 2 Controls   - epilepsy indication  - epilepsy indication 2.35[0.96; 5.77]272175 -NABjørk (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2022 1 All studiesAll studies 2.36[1.00; 5.54]4,5522590%NABjørk (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2022 Coste (Phenobarbital) (Controls unexposed, NOS), 2020 20.55.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

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

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded 9160, 12782, 12785

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.47[0.64; 3.40]42,7222590%NABjørk (Phenobarbital) (Controls unexposed NOS) (Mixed indications), 2022 Coste (Phenobarbital) (Controls unexposed, NOS), 2020 2 unexposed, sick controlsunexposed, sick controls 2.35[0.96; 5.77]272175 -NABjørk (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2022 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 2.68[1.12; 6.40]972590%NABjørk (Phenobarbital) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2022 Coste (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2020 20.510.01.0