Valproate (All indications)

Elective/induced termination of pregnancy

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.
S12882
R48684		 Hosny (Valproate) (Controls exposed to Lamotrigine, sick), 2021 Induced abortion 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.07 [0.00;8.55] C
excluded (control group) 		0/8   0/1 0 8
ref
S12883
R48687		 Hosny (Valproate) (Controls unexposed, sick), 2021 Induced abortion 1st trimester prospective cohort unexposed, sick Adjustment: No 2.73 [0.05;150.47] C 0/8   0/21 0 8
ref
S9320
R32476		 Miškov (Valproate) (Controls exposed to Lamotrigine, sick), 2016 Artificial abortion during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 2.15 [0.08;59.77] C
excluded (control group) 		0/6   1/37 1 6
ref
S9321
R32480		 Miškov (Valproate) (Controls unexposed, disease free), 2016 Artificial abortion during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: No 23.18 [0.42;1280.78] C
excluded (control group) 		0/6   0/128 0 6
ref
S9322
R32484		 Miškov (Valproate) (Controls unexposed, sick), 2016 Artificial abortion during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.64 [0.01;40.08] C 0/6   0/4 0 6
ref
S9333
R32566		 Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 Induced abortions 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 1.88 [0.80;4.44] C 11/1,290   10/2,198 21 1,290
ref
Total 3 studies 1.83 [0.80;4.17] 21 1,304
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 Hosny (Valproate) (Controls unexposed, sick), 2021Hosny, 2021 1 2.73[0.05; 150.47]084%ROB confusion: criticalROB selection: moderateROB classification: unclearROB missing: lowROB mesure: unclearROB reporting: moderate Miškov (Valproate) (Controls unexposed, sick), 2016Miškov, 2016 2 0.64[0.01; 40.08]064%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014Campbell, 2014 3 1.88[0.80; 4.44]211,29092%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 0% 1.83[0.80; 4.17]211,3040.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.83[0.80; 4.17]211,3040%NAHosny (Valproate) (Controls unexposed, sick), 2021 Miškov (Valproate) (Controls unexposed, sick), 2016 Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 3 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.35[0.08; 24.08]-140%NAHosny (Valproate) (Controls unexposed, sick), 2021 Miškov (Valproate) (Controls unexposed, sick), 2016 2 exposed to other treatment, sickexposed to other treatment, sick 1.88[0.80; 4.44]211,290 -NACampbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 1 Tags Adjustment   - No  - No 1.83[0.80; 4.17]211,3040%NAHosny (Valproate) (Controls unexposed, sick), 2021 Miškov (Valproate) (Controls unexposed, sick), 2016 Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 3 All studiesAll studies 1.83[0.80; 4.17]211,3040%NAHosny (Valproate) (Controls unexposed, sick), 2021 Miškov (Valproate) (Controls unexposed, sick), 2016 Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 30.210.01.0

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 9320, 9321, 12882

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) Out of scale23.18[0.42; 1280.78]-6 -NAMiškov (Valproate) (Controls unexposed, disease free), 2016 1 unexposed, sick controlsunexposed, sick controls 1.35[0.08; 24.08]-140%NAHosny (Valproate) (Controls unexposed, sick), 2021 Miškov (Valproate) (Controls unexposed, sick), 2016 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.72[0.76; 3.92]221,3040%NAHosny (Valproate) (Controls exposed to Lamotrigine, sick), 2021 Miškov (Valproate) (Controls exposed to Lamotrigine, sick), 2016 Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 30.510.01.0