Phenytoin (All indications)

Minor congenital malformations

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.
S9196
R31898		 Dean (Phenytoin), 2002 Minor congenital malformations at least 1st trimester retrospective cohort unexposed, sick Adjustment: No 3.71 [1.07;12.90] C 9/25   5/38 14 25
ref
S9223
R31999		 Wide (Phenytoin), 2000 Minor anomalies throughout pregnancy prospective cohort unexposed (general population or NOS) Adjustment: No Matched 0.80 [0.22;2.98] 5/21   6/19 11 21
ref
S9273
R32158		 Nulman (Phenytoin) (Controls unexposed, NOS) (Mixed indications), 1997 Minor anomalies at least 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Matched 3.95 [1.34;11.60] C 26/33   16/33 42 33
ref
S9226
R32024		 Battino (Phenytoin), 1992 Minor anomalies 1st trimester prospective cohort unexposed, sick Adjustment: No 3.40 [0.16;70.12] C 4/27   0/9 4 27
ref
Total 4 studies 2.46 [1.09;5.57] 71 106
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 Dean (Phenytoin), 2002Dean, 2002 1 3.71[1.07; 12.90]142530%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Wide (Phenytoin), 2000Wide, 2000 2 0.80[0.22; 2.98]112128%ROB confusion: criticalROB selection: moderateROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Nulman (Phenytoin) (Controls unexposed, NOS) (Mixed indications), 1997Nulman, 1997 3 3.95[1.34; 11.60]423336%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Battino (Phenytoin), 1992Battino, 1992 4 3.40[0.16; 70.12]4277%ROB confusion: criticalROB selection: moderateROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Total (4 studies) I2 = 26% 2.46[1.09; 5.57]711060.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Phenytoin; 2: Phenytoin; 3: Phenytoin) (Controls unexposed, NOS) (Mixed indications; 4: Phenytoin;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 2.46[1.09; 5.57]7110626%NADean (Phenytoin), 2002 Wide (Phenytoin), 2000 Nulman (Phenytoin) (Controls unexposed, NOS) (Mixed indications), 1997 Battino (Phenytoin), 1992 4 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.86[0.39; 8.85]535471%NAWide (Phenytoin), 2000 Nulman (Phenytoin) (Controls unexposed, NOS) (Mixed indications), 1997 2 unexposed, sickunexposed, sick 3.67[1.16; 11.60]18520%NADean (Phenytoin), 2002 Battino (Phenytoin), 1992 2 Tags Adjustment   - No  - No 2.46[1.09; 5.57]7110626%NADean (Phenytoin), 2002 Wide (Phenytoin), 2000 Nulman (Phenytoin) (Controls unexposed, NOS) (Mixed indications), 1997 Battino (Phenytoin), 1992 4 MatchedMatched 1.86[0.39; 8.85]535471%NAWide (Phenytoin), 2000 Nulman (Phenytoin) (Controls unexposed, NOS) (Mixed indications), 1997 2 All studiesAll studies 2.46[1.09; 5.57]7110626%NADean (Phenytoin), 2002 Wide (Phenytoin), 2000 Nulman (Phenytoin) (Controls unexposed, NOS) (Mixed indications), 1997 Battino (Phenytoin), 1992 40.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.64.51.8530.000Dean (Phenytoin), 2002Wide (Phenytoin), 2000Nulman (Phenytoin) (Controls unexposed, NOS) (Mixed indications), 1997Battino (Phenytoin), 1992

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 controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.86[0.39; 8.85]535471%NAWide (Phenytoin), 2000 Nulman (Phenytoin) (Controls unexposed, NOS) (Mixed indications), 1997 2 unexposed, sick controlsunexposed, sick controls 3.67[1.16; 11.60]18520%NADean (Phenytoin), 2002 Battino (Phenytoin), 1992 20.510.01.0