Carbamazepine (All indications)

ADHD (Attention deficit hyperactivity disorder): Diagnosis

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.
S15231
R62555		 Dreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Attention-deficit/hyperactivity disorder (ADHD) - Corresponding ICD-10 F-chapter - Up to 22 years of age during pregnancy (anytime or not specified) population based cohort propective exposed to other treatment, sick excluded Adjustment: No 1.89 [1.41;2.53] C
excluded (control group) 		89/2,665   95/5,288 184 2,665
ref
S15235
R62609		 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Attention-deficit/hyperactivity disorder (ADHD) - Corresponding ICD-10 F-chapter - Up to 22 years of age during pregnancy (anytime or not specified) population based cohort propective unexposed, sick Adjustment: Yes 1.05 [0.81;1.37] 89/2,665   528/22,203 617 2,665
ref
S9749
R34811		 Wiggs (Carbamazepine), 2020 Attention-deficit/hyperactivity disorder (after 2 years of age) at least 1st trimester population based cohort retrospective unexposed, sick Adjustment: Yes 1.18 [0.91;1.52] -/-   -/11,298 - -
ref
S9723
R34605		 Huber-Mollema (Carbamazepine), 2019 Diagnosis of ADHD throughout pregnancy prospective cohort exposed to other treatment, sick Adjustment: No 0.95 [0.18;5.12] C 2/37   5/88 7 37
ref
S9696
R34508		 Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Attention deficit hyperactivity disorder (at 6 years old) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.82 [0.07;46.28] C
excluded (control group) 		1/50   0/30 1 50
ref
S9699
R34524		 Bromley (Carbamazepine) (Controls unexposed, disease free), 2013 Attention deficit hyperactivity disorder (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: No 13.21 [0.53;329.15] C
excluded (control group) 		1/50   0/214 1 50
ref
S9702
R34540		 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Attention deficit hyperactivity disorder (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 1.58 [0.06;40.13] C 1/50   0/26 1 50
ref
S9711
R34559		 Cohen (Carbamazepine), 2013 Children with either ADHD inattentive OR combined types > 1 SD (from the Attention Problems and Hyperactivity scales of the BASC) (Both Parent and Teacher) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 0.96 [0.22;4.25] C 4/32   4/31 8 32
ref
Total 5 studies 1.11 [0.93;1.33] 633 2,784
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 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Dreier, 2023 1 1.05[0.81; 1.37]6172,66547%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Wiggs (Carbamazepine), 2020Wiggs, 2020 2 1.18[0.91; 1.52]--50%ROB confusion: moderateROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Huber-Mollema (Carbamazepine), 2019Huber-Mollema, 2019 3 0.95[0.18; 5.12]7371%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Bromley (Carbamazepine) (Controls unexposed, sick), 2013Bromley, 2013 4 1.58[0.06; 40.13]1500%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Cohen (Carbamazepine), 2013Cohen, 2013 5 0.96[0.22; 4.25]8321%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: criticalROB mesure: lowROB reporting: low Total (5 studies) I2 = 0% 1.11[0.93; 1.33]6332,7840.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Carbamazepine) (Epilepsy) (Controls unexposed, sick; 2: Carbamazepine; 3: Carbamazepine; 4: Carbamazepine) (Controls unexposed, sick; 5: Carbamazepine;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.11[0.93; 1.33]6332,7840%NADreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Wiggs (Carbamazepine), 2020 Huber-Mollema (Carbamazepine), 2019 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Cohen (Carbamazepine), 2013 5 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.12[0.93; 1.34]6182,7150%NADreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Wiggs (Carbamazepine), 2020 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 3 exposed to other treatment, sickexposed to other treatment, sick 0.96[0.31; 2.92]15690%NAHuber-Mollema (Carbamazepine), 2019 Cohen (Carbamazepine), 2013 2 Tags Adjustment   - No  - No 1.01[0.35; 2.89]161190%NAHuber-Mollema (Carbamazepine), 2019 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Cohen (Carbamazepine), 2013 3   - Yes  - Yes 1.11[0.93; 1.34]6172,6650%NADreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Wiggs (Carbamazepine), 2020 2 All studiesAll studies 1.11[0.93; 1.33]6332,7840%NADreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Wiggs (Carbamazepine), 2020 Huber-Mollema (Carbamazepine), 2019 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Cohen (Carbamazepine), 2013 50.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.94.01.9810.000Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Wiggs (Carbamazepine), 2020Huber-Mollema (Carbamazepine), 2019Bromley (Carbamazepine) (Controls unexposed, sick), 2013Cohen (Carbamazepine), 2013

Asymetry test p-value = 0.8471 (by Egger's regression)

slope=0.1146 (0.0568); intercept=-0.0578 (0.2751); t=0.2100; p=0.8471

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 9696, 9699, 15231

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) Out of scale13.21[0.53; 329.15]150 -NABromley (Carbamazepine) (Controls unexposed, disease free), 2013 1 unexposed, sick controlsunexposed, sick controls 1.12[0.93; 1.34]6182,7150%NADreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Wiggs (Carbamazepine), 2020 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.81[1.36; 2.40]2002,7840%NADreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Huber-Mollema (Carbamazepine), 2019 Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Cohen (Carbamazepine), 2013 40.510.01.0