Phenytoin (All indications)

Language disorders/delay

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.
S12898
R48734		 Adams (Phenytoin), 2022 Verbal IQ - The Wechsler Intelligence Scale for Children, 3rd Edition (WISC-III) (mean >6 years old) during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No extrapolated (cont. endpoint) Matched 1.11 [0.50;2.45] -/40   -/40 - 40
ref
S15272
R62773		 Thomas (Phenytoin), 2022 Verbal IQ/Verbal comprehension index (VCI) - Wechsler Intelligence Scale for Children or Adult - Ages 13 to 21 years (mean of 16.5 ± 2.2 years) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No extrapolated (cont. endpoint) 2.05 [0.43;9.86] -/10   -/11 - 10
ref
S9266
R32139		 Meador (Phenytoin), 2013 Verbal index score (at age 6 years old) (Created by averaging standard scores) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: Yes extrapolated (cont. endpoint) 0.85 [0.42;1.71] -/40   -/74 - 40
ref
S9271
R32149		 Vinten (Phenytoin), 2005 Verbal IQ score <69 (Wechsler Intelligence Scale for Children (WISC III)) during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No 0.28 [0.01;5.10] C 0/21   6/80 6 21
ref
Total 4 studies 0.99 [0.61;1.63] 6 111
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 Adams (Phenytoin), 2022Adams, 2022 1 1.11[0.50; 2.45]-4038%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: lowROB reporting: moderate Thomas (Phenytoin), 2022Thomas, 2022 2 2.05[0.43; 9.86]-1010%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: criticalROB mesure: lowROB reporting: moderate Meador (Phenytoin), 2013Meador, 2013 3 0.85[0.42; 1.71]-4049%ROB confusion: moderateROB selection: lowROB classification: lowROB missing: moderateROB mesure: lowROB reporting: low Vinten (Phenytoin), 2005Vinten, 2005 4 0.28[0.01; 5.10]6213%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: criticalROB mesure: lowROB reporting: moderate Total (4 studies) I2 = 0% 0.99[0.61; 1.63]61110.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Phenytoin; 2: Phenytoin; 3: Phenytoin; 4: Phenytoin;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.99[0.61; 1.63]61110%NAAdams (Phenytoin), 2022 Thomas (Phenytoin), 2022 Meador (Phenytoin), 2013 Vinten (Phenytoin), 2005 4 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.16[0.58; 2.30]6710%NAAdams (Phenytoin), 2022 Thomas (Phenytoin), 2022 Vinten (Phenytoin), 2005 3 exposed to other treatment, sickexposed to other treatment, sick 0.85[0.42; 1.72]-40 -NAMeador (Phenytoin), 2013 1 Tags Adjustment   - No  - No 1.16[0.58; 2.30]6710%NAAdams (Phenytoin), 2022 Thomas (Phenytoin), 2022 Vinten (Phenytoin), 2005 3   - Yes  - Yes 0.85[0.42; 1.72]-40 -NAMeador (Phenytoin), 2013 1 extrapolated (cont. endpoint)extrapolated (cont. endpoint) 1.03[0.63; 1.70]-900%NAAdams (Phenytoin), 2022 Thomas (Phenytoin), 2022 Meador (Phenytoin), 2013 3 MatchedMatched 1.11[0.50; 2.46]-40 -NAAdams (Phenytoin), 2022 1 All studiesAll studies 0.99[0.61; 1.63]61110%NAAdams (Phenytoin), 2022 Thomas (Phenytoin), 2022 Meador (Phenytoin), 2013 Vinten (Phenytoin), 2005 40.15.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.53.51.7860.000Adams (Phenytoin), 2022Thomas (Phenytoin), 2022Meador (Phenytoin), 2013Vinten (Phenytoin), 2005

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

not enought points

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed, sick controlsunexposed, sick controls 1.16[0.58; 2.30]6710%NAAdams (Phenytoin), 2022 Thomas (Phenytoin), 2022 Vinten (Phenytoin), 2005 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.85[0.42; 1.72]-40 -NAMeador (Phenytoin), 2013 10.510.01.0