Valproate (All indications)

Digestive system anomalies

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.
S12862
R48540		 Thomas (Valproate) (Controls exposed to Lamotrigine, sick), 2021 Gastro-intestinal malformations 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.15 [0.00;7.41] C
excluded (control group) 		0/341   0/50 0 341
ref
S12864
R48552		 Thomas (Valproate) (Controls unexposed, sick), 2021 Gastro-intestinal malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 0.33 [0.01;8.16] C 0/341   1/340 1 341
ref
S9333
R32561		 Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 Gastrointestinal tract defect 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 1.51 [0.55;4.17] C 7/1,220   8/2,098 15 1,220
ref
S9325
R32509		 Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 Digestive throughout pregnancy population based cohort retrospective exposed to other treatment, sick Adjustment: No 1.88 [0.42;8.46] C 3/333   4/833 7 333
ref
Total 3 studies 1.46 [0.65;3.30] 23 1,894
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 (Valproate) (Controls unexposed, sick), 2021Thomas, 2021 1 0.33[0.01; 8.16]13416%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014Campbell, 2014 2 1.51[0.55; 4.17]151,22064%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014Veiby, 2014 3 1.88[0.42; 8.46]733329%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 0% 1.46[0.65; 3.30]231,8940.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Valproate) (Controls unexposed, sick; 2: Valproate) (Controls exposed to Lamotrigine, sick; 3: Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.46[0.65; 3.30]231,8940%NAThomas (Valproate) (Controls unexposed, sick), 2021 Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 3 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 0.33[0.01; 8.16]1341 -NAThomas (Valproate) (Controls unexposed, sick), 2021 1 exposed to other treatment, sickexposed to other treatment, sick 1.62[0.70; 3.75]221,5530%NACampbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 2 Tags Adjustment   - No  - No 1.46[0.65; 3.30]231,8940%NAThomas (Valproate) (Controls unexposed, sick), 2021 Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 3 All studiesAll studies 1.46[0.65; 3.30]231,8940%NAThomas (Valproate) (Controls unexposed, sick), 2021 Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 30.15.01.0

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 12862

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed, sick controlsunexposed, sick controls Out of scale0.33[0.01; 8.16]1341 -NAThomas (Valproate) (Controls unexposed, sick), 2021 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.45[0.64; 3.31]221,8940%NAThomas (Valproate) (Controls exposed to Lamotrigine, sick), 2021 Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 30.510.01.0