Valproate (All indications)

Club foot / Talipes equinovarus

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.
S15201
R62353		 Cohen (Valproate) (Mixed indications) (Controls unexposed, NOS), 2023 Clubfoot 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 5.04 [3.55;7.15] -/2,031   -/4,866,362 - 2,031
ref
S10174
R37223		 Blotière (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2019 Talipes equinovarus 1st trimester retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 0.66 [0.03;13.68] C
excluded (control group) 		0/913   2/2,997 2 913
ref
S10051
R36497		 Blotière (Valproate) (Controls unexposed NOS) (Mixed indications), 2019 Talipes equinovarus 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 0.61 [0.04;9.80] C 0/913   1,677/1,875,733 1,677 913
ref
S9309
R32429		 Källén (Valproate) (Controls exposed to Lamotrigine, sick) (Indications NOS), 2013 Pes equinovarus early pregnancy population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 9.40 [1.13;78.28] C
excluded (control group) 		6/697   1/1,084 7 697
ref
S9310
R32437		 Källén (Valproate) (Controls unexposed, NOS) (Indications NOS), 2013 Pes equinovarus early pregnancy population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 6.12 [2.25;13.30] 6/697   2,127/1,575,847 2,133 697
ref
Total 3 studies 4.97 [3.12;7.91] 3,810 3,641
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 Cohen (Valproate) (Mixed indications) (Controls unexposed, NOS), 2023Cohen, 2023 1 5.04[3.55; 7.15]-2,03175%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Blotière (Valproate) (Controls unexposed NOS) (Mixed indications), 2019Blotière, 2019 2 0.61[0.04; 9.80]1,6779133%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Källén (Valproate) (Controls unexposed, NOS) (Indications NOS), 2013Källén, 2013 3 6.12[2.25; 13.30]2,13369723%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 17% 4.97[3.12; 7.91]3,8103,6410.220.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Valproate) (Mixed indications) (Controls unexposed, NOS; 2: Valproate) (Controls unexposed NOS) (Mixed indications; 3: Valproate) (Controls unexposed, NOS) (Indications NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 4.97[3.12; 7.91]3,8103,64117%NACohen (Valproate) (Mixed indications) (Controls unexposed, NOS), 2023 Blotière (Valproate) (Controls unexposed NOS) (Mixed indications), 2019 Källén (Valproate) (Controls unexposed, NOS) (Indications NOS), 2013 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 4.97[3.12; 7.91]3,8103,64117%NACohen (Valproate) (Mixed indications) (Controls unexposed, NOS), 2023 Blotière (Valproate) (Controls unexposed NOS) (Mixed indications), 2019 Källén (Valproate) (Controls unexposed, NOS) (Indications NOS), 2013 3 Tags Adjustment   - No  - No 0.61[0.04; 9.80]1,677913 -NABlotière (Valproate) (Controls unexposed NOS) (Mixed indications), 2019 1   - Yes  - Yes 5.17[3.74; 7.17]2,1332,7280%NACohen (Valproate) (Mixed indications) (Controls unexposed, NOS), 2023 Källén (Valproate) (Controls unexposed, NOS) (Indications NOS), 2013 2 All studiesAll studies 4.97[3.12; 7.91]3,8103,64117%NACohen (Valproate) (Mixed indications) (Controls unexposed, NOS), 2023 Blotière (Valproate) (Controls unexposed NOS) (Mixed indications), 2019 Källén (Valproate) (Controls unexposed, NOS) (Indications NOS), 2013 30.220.01.0

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 9309, 10174

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 4.97[3.12; 7.91]3,8103,64117%NACohen (Valproate) (Mixed indications) (Controls unexposed, NOS), 2023 Blotière (Valproate) (Controls unexposed NOS) (Mixed indications), 2019 Källén (Valproate) (Controls unexposed, NOS) (Indications NOS), 2013 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 3.13[0.24; 40.88]91,61050%NABlotière (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2019 Källén (Valproate) (Controls exposed to Lamotrigine, sick) (Indications NOS), 2013 20.510.01.0