Phenytoin (All indications)

Urinary 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.
S12850
R48455		 Thomas (Phenytoin) (Controls exposed to Lamotrigine, sick), 2021 Urinary malformations 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.14 [0.01;3.41] C
excluded (control group) 		0/119   1/50 1 119
ref
S12852
R48467		 Thomas (Phenytoin) (Controls unexposed, sick), 2021 Urinary malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 0.22 [0.01;3.87] C 0/119   6/340 6 119
ref
S9246
R32083		 Tomson (Phenytoin), 2018 Renal malformations at least 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 1.18 [0.07;20.63] C 0/125   8/2,514 8 125
ref
S9224
R32009		 Artama (Phenytoin), 2005 Urinary system 1st trimester retrospective cohort (registry) unexposed, sick Adjustment: No 8.33 [0.33;208.00] C 0/38   1/939 1 38
ref
Total 3 studies 1.17 [0.16;8.76] 15 282
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 (Phenytoin) (Controls unexposed, sick), 2021Thomas, 2021 1 0.22[0.01; 3.87]611935%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Tomson (Phenytoin), 2018Tomson, 2018 2 1.18[0.07; 20.63]812535%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Artama (Phenytoin), 2005Artama, 2005 3 8.33[0.33; 208.00]13830%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (3 studies) I2 = 27% 1.17[0.16; 8.76]152820.220.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Phenytoin) (Controls unexposed, sick; 2: Phenytoin; 3: Phenytoin;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.17[0.16; 8.76]1528227%NAThomas (Phenytoin) (Controls unexposed, sick), 2021 Tomson (Phenytoin), 2018 Artama (Phenytoin), 2005 3 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.25[0.04; 44.58]715764%NAThomas (Phenytoin) (Controls unexposed, sick), 2021 Artama (Phenytoin), 2005 2 exposed to other treatment, sickexposed to other treatment, sick 1.18[0.07; 20.63]8125 -NATomson (Phenytoin), 2018 1 Tags Adjustment   - No  - No 1.17[0.16; 8.76]1528227%NAThomas (Phenytoin) (Controls unexposed, sick), 2021 Tomson (Phenytoin), 2018 Artama (Phenytoin), 2005 3 All studiesAll studies 1.17[0.16; 8.76]1528227%NAThomas (Phenytoin) (Controls unexposed, sick), 2021 Tomson (Phenytoin), 2018 Artama (Phenytoin), 2005 30.120.01.0

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 12850

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed, sick controlsunexposed, sick controls 1.25[0.04; 44.58]715764%NAThomas (Phenytoin) (Controls unexposed, sick), 2021 Artama (Phenytoin), 2005 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls Out of scale0.46[0.05; 3.87]92440%NAThomas (Phenytoin) (Controls exposed to Lamotrigine, sick), 2021 Tomson (Phenytoin), 2018 20.510.01.0