Carbamazepine (All indications)

Polydactyly

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.
S9678
R34454		 Tomson (Carbamazepine), 2018 Polydactyly at least 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 6.43 [0.31;134.02] C 2/1,957   0/2,514 2 1,957
ref
S9625
R34229		 Källén (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Indications NOS), 2013 Poly/syndactyly early pregnancy population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 1.20 [0.29;5.02] C
excluded (control group) 		5/1,511   3/1,084 8 1,511
ref
S9626
R34237		 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 Poly/syndactyly early pregnancy population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 1.45 [0.47;3.38] 5/1,511   3,084/1,575,847 3,089 1,511
ref
S9648
R34334		 Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006 Polydactyly throughout pregnancy prospective cohort unexposed, sick Adjustment: No 2.19 [0.09;54.89] C 1/72   0/52 1 72
ref
S9612
R34088		 D'Souza (Carbamazepine) (Controls unexposed, disease free), 1991 Extra digits throughout pregnancy prospective cohort unexposed, disease free excluded Adjustment: No Matched 123.00 [3.40;4444.20] C
excluded (control group) 		1/3   0/62 1 3
ref
S9613
R34117		 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 Extra digits throughout pregnancy prospective cohort unexposed, sick Adjustment: No 15.00 [0.39;576.73] C 1/3   0/8 1 3
ref
Total 4 studies 1.93 [0.81;4.64] 3,093 3,543
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 Tomson (Carbamazepine), 2018Tomson, 2018 1 6.43[0.31; 134.02]21,9578%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013Källén, 2013 2 1.45[0.47; 3.38]3,0891,51179%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006Viinikainen, 2006 3 2.19[0.09; 54.89]1727%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate D'Souza (Carbamazepine) (Controls unexposed, sick), 1991D'Souza, 1991 4 15.00[0.39; 576.73]136%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (4 studies) I2 = 0% 1.93[0.81; 4.64]3,0933,5430.550.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.93[0.81; 4.64]3,0933,5430%NATomson (Carbamazepine), 2018 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 4 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.45[0.54; 3.89]3,0891,511 -NAKällén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 1 unexposed, sickunexposed, sick 5.09[0.45; 56.92]2750%NAViinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 2 exposed to other treatment, sickexposed to other treatment, sick 6.43[0.31; 134.02]21,957 -NATomson (Carbamazepine), 2018 1 Tags Adjustment   - No  - No 5.57[0.84; 36.88]42,0320%NATomson (Carbamazepine), 2018 Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 3   - Yes  - Yes 1.45[0.54; 3.89]3,0891,511 -NAKällén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 1 All studiesAll studies 1.93[0.81; 4.64]3,0933,5430%NATomson (Carbamazepine), 2018 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 40.550.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.45.02.2340.000Tomson (Carbamazepine), 2018Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006D'Souza (Carbamazepine) (Controls unexposed, sick), 1991

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

not enought points

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 9612, 9625

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 9.42[0.13; 693.03]3,0901,51482%NAKällén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 D'Souza (Carbamazepine) (Controls unexposed, disease free), 1991 2 unexposed, sick controlsunexposed, sick controls 1.95[0.23; 16.74]48517%NABànhidy (Carbamazepine), 2011 Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.63[0.44; 5.94]103,4680%NATomson (Carbamazepine), 2018 Källén (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Indications NOS), 2013 20.510.01.0