Carbamazepine (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.
S15198
R62338		 Cohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Clubfoot 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Partial overlapping 0.48 [0.18;1.27] -/2,674   -/4,866,362 - 2,674
ref
S10176
R37269		 Blotière (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2019 Talipes equinovarus 1st trimester retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 1.17 [0.06;24.43] C
excluded (control group) 		0/512   2/2,997 2 512
ref
S9766
R34919		 Blotière (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Talipes equinovarus 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 1.09 [0.07;17.49] C 0/512   1,677/1,875,733 1,677 512
ref
S9625
R34228		 Källén (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Indications NOS), 2013 Pes equinovarus early pregnancy population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No Partial overlapping 3.60 [0.42;30.82] C
excluded (control group) 		5/1,511   1/1,084 6 1,511
ref
S9626
R34236		 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 Pes equinovarus early pregnancy population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Partial overlapping 2.23 [0.72;5.21] 5/1,511   2,127/1,575,847 2,132 1,511
ref
S9653
R34361		 Bànhidy (Carbamazepine), 2011 Clubfoot throughout pregnancy case control unexposed, sick Adjustment: No Matched 3.32 [0.12;91.61] C 2/12   0/10 2 12
ref
S9740
R34717		 Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991 Talipes throughout pregnancy prospective cohort unexposed, disease free excluded Adjustment: No Matched 5.19 [0.10;276.47] C
excluded (control group) 		0/11   0/55 0 11
ref
S9741
R34742		 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 Talipes throughout pregnancy prospective cohort unexposed, sick Adjustment: No 2.05 [0.04;110.56] C 0/11   0/22 0 11
ref
Total 5 studies 1.15 [0.48;2.71] 3,811 4,720
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 (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023Cohen, 2023 1 0.48[0.18; 1.27]-2,67441%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Blotière (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019Blotière, 2019 2 1.09[0.07; 17.49]1,6775129%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013Källén, 2013 3 2.23[0.72; 5.21]2,1321,51140%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Bànhidy (Carbamazepine), 2011Bànhidy, 2011 4 3.32[0.12; 91.61]2126%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991Van der Pol, 1991 5 2.05[0.04; 110.56]0114%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 24% 1.15[0.48; 2.71]3,8114,7200.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Carbamazepine) (Mixed indications) (Controls unexposed, NOS; 2: Carbamazepine) (Controls unexposed NOS) (Mixed indications; 3: Carbamazepine) (Controls unexposed, NOS) (Indications NOS; 4: Carbamazepine; 5: Carbamazepine) (Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.08[0.40; 2.90]3,8094,70838%NACohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Blotière (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 4 case control studiescase control studies 3.32[0.12; 91.61]212 -NABànhidy (Carbamazepine), 2011 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.04[0.32; 3.35]3,8094,69757%NACohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Blotière (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 3 unexposed, sickunexposed, sick 2.72[0.21; 34.91]2230%NABànhidy (Carbamazepine), 2011 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 2 Tags Adjustment   - No  - No 1.79[0.27; 11.71]1,6795350%NABlotière (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Bànhidy (Carbamazepine), 2011 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 3   - Yes  - Yes 1.03[0.23; 4.65]2,1324,18579%NACohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 2 MatchedMatched 3.32[0.12; 91.61]212 -NABànhidy (Carbamazepine), 2011 1 Partial overlappingPartial overlapping 1.03[0.23; 4.65]2,1324,18579%NACohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 2 All studiesAll studies 1.15[0.48; 2.71]3,8114,72024%NACohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Blotière (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 Bànhidy (Carbamazepine), 2011 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 50.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.84.92.4420.000Cohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023Blotière (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013Bànhidy (Carbamazepine), 2011Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991

Asymetry test p-value = 0.6594 (by Egger's regression)

slope=-0.2549 (0.8274); intercept=0.5421 (1.1124); t=0.4873; p=0.6594

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 9740, 9625, 10176

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.15[0.40; 3.31]3,8094,70843%NACohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Blotière (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991 4 unexposed, sick controlsunexposed, sick controls 2.72[0.21; 34.91]2230%NABànhidy (Carbamazepine), 2011 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 2.47[0.43; 14.29]82,0230%NABlotière (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2019 Källén (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Indications NOS), 2013 20.510.01.0