Valproate (All indications)

Cardiac septal defects

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.
S9325
R32513		 Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 Cardiac septal throughout pregnancy population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 1.89 [0.65;5.50] C
excluded (control group) 		6/333   8/833 14 333
ref
S9326
R32520		 Veiby (Valproate) (Controls unexposed, disease free) (Mixed indications), 2014 Cardiac septal throughout pregnancy population based cohort retrospective unexposed, disease free Adjustment: Yes 2.69 [1.20;6.03] 6/333   5,400/771,412 5,406 333
ref
S9309
R32427		 Källén (Valproate) (Controls exposed to Lamotrigine, sick) (Indications NOS), 2013 Septum defect early pregnancy population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 1.91 [0.94;3.90] C
excluded (control group) 		17/697   14/1,084 31 697
ref
S9310
R32435		 Källén (Valproate) (Controls unexposed, NOS) (Indications NOS), 2013 Septum defect early pregnancy population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 2.66 [1.55;4.27] 17/697   11,155/1,575,847 11,172 697
ref
Total 2 studies 2.67 [1.74;4.10] 16,578 1,030
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 Veiby (Valproate) (Controls unexposed, disease free) (Mixed indications), 2014Veiby, 2014 1 2.69[1.20; 6.03]5,40633328%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Källén (Valproate) (Controls unexposed, NOS) (Indications NOS), 2013Källén, 2013 2 2.66[1.55; 4.27]11,17269772%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Total (2 studies) I2 = 0% 2.67[1.74; 4.10]16,5781,0300.910.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 2.67[1.74; 4.10]16,5781,0300%NAVeiby (Valproate) (Controls unexposed, disease free) (Mixed indications), 2014 Källén (Valproate) (Controls unexposed, NOS) (Indications NOS), 2013 2 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 2.67[1.74; 4.10]16,5781,0300%NAVeiby (Valproate) (Controls unexposed, disease free) (Mixed indications), 2014 Källén (Valproate) (Controls unexposed, NOS) (Indications NOS), 2013 2 Tags Adjustment   - Yes  - Yes 2.67[1.74; 4.10]16,5781,0300%NAVeiby (Valproate) (Controls unexposed, disease free) (Mixed indications), 2014 Källén (Valproate) (Controls unexposed, NOS) (Indications NOS), 2013 2 All studiesAll studies 2.67[1.74; 4.10]16,5781,0300%NAVeiby (Valproate) (Controls unexposed, disease free) (Mixed indications), 2014 Källén (Valproate) (Controls unexposed, NOS) (Indications NOS), 2013 20.510.01.0

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, 9325

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 2.67[1.74; 4.10]16,5781,0300%NAVeiby (Valproate) (Controls unexposed, disease free) (Mixed indications), 2014 Källén (Valproate) (Controls unexposed, NOS) (Indications NOS), 2013 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.90[1.05; 3.45]451,0300%NAVeiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 Källén (Valproate) (Controls exposed to Lamotrigine, sick) (Indications NOS), 2013 20.510.01.0