Ondansetron

Cleft lip with or without cleft palate

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.
S2757
R3952		 Zambelli-Weiner (Unexposed control, NOS), 2019 Cleft lip with or without cleft palate 1st trimester nested case control unexposed (general population or NOS) Adjustment: Yes 1.69 [0.84;3.40] 8/886   696/113,802 704 886
ref
S2852
R4648		 Huybrechts (Control exposed to other treatment), 2018 Cleft lip and Cleft lip and palate 1st trimester retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 0.93 [0.68;1.27] C
excluded (control group) 		50/55,579   180/185,699 230 55,579
ref
S2844
R4649		 Huybrechts (Unexposed control), 2018 Cleft lip and Cleft lip and palate 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 1.02 [0.82;1.28] C 81/88,446   1,545/1,727,925 1,626 88,446
ref
S2853
R3964		 Parker, BDS study, 2018 Cleft lip with or without cleft palate 1st trimester case control unexposed, sick Adjustment: Yes 0.80 [0.50;1.20] 27/402   450/5,948 477 402
ref
S2756
R3679		 Parker, NBDPS study, 2018 Cleft lip with or without cleft palate 1st trimester case control unexposed, sick Adjustment: Yes 1.10 [0.80;1.50] 56/268   772/3,827 828 268
ref
S2778
R3785		 Fejzo (Mainly exposed to other treatements, sick), 2016 Cleft lip/palate 1st trimester retrospective cohort exposed to other treatment, sick excluded Adjustment: No 1.39 [0.06;34.20] C
excluded (control group) 		1/952   0/441 1 952
ref
S2776
R3747		 Fejzo (Unexposed control, disease free), 2016 Cleft lip/palate 1st trimester retrospective cohort unexposed, disease free Adjustment: No 0.68 [0.06;7.46] C 1/952   2/1,286 3 952
ref
S2746
R3895		 Pasternak, 2013 Cleft lip with or without cleft palate 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: No 1.09 [0.30;3.92] C 3/1,233   11/4,932 14 1,233
ref
S2747
R3642		 Anderka, 2012 Cleft lip with or without cleft palate 1st trimester case control unexposed, sick Adjustment: Yes 0.88 [0.38;2.00] 7/51   926/4,891 933 51
ref
Total 7 studies 1.03 [0.88;1.21] 4,585 92,238
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 Zambelli-Weiner (Unexposed control, NOS), 2019Zambelli-Weiner, 2019 1 1.69[0.84; 3.40]7048865%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Huybrechts (Unexposed control), 2018Huybrechts, 2018 2 1.02[0.82; 1.28]1,62688,44650%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Parker, BDS study, 2018Parker, BDS study, 2018 0.80[0.50; 1.20]47740213%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Parker, NBDPS study, 2018Parker, NBDPS study, 2018 1.10[0.80; 1.50]82826826%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Fejzo (Unexposed control, disease free), 2016Fejzo, 2016 3 0.68[0.06; 7.46]39520%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Pasternak, 2013Pasternak, 2013 1.09[0.30; 3.92]141,2332%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Anderka, 2012Anderka, 2012 0.88[0.38; 2.00]933514%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (7 studies) I2 = 0% 1.03[0.88; 1.21]4,58592,2380.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Unexposed control, NOS; 2: Unexposed control; 3: Unexposed control, disease free;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.02[0.82; 1.27]1,64390,6310%NAHuybrechts (Unexposed control), 2018 Fejzo (Unexposed control, disease free), 2016 Pasternak, 2013 3 case control studiescase control studies 1.04[0.80; 1.35]2,9421,60715%NAZambelli-Weiner (Unexposed control, NOS), 2019 Parker, BDS study, 2018 Parker, NBDPS study, 2018 Anderka, 2012 4 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.07[0.87; 1.32]2,34791,5170%NAZambelli-Weiner (Unexposed control, NOS), 2019 Huybrechts (Unexposed control), 2018 Fejzo (Unexposed control, disease free), 2016 Pasternak, 2013 4 unexposed, sickunexposed, sick 0.98[0.77; 1.25]2,2387210%NAParker, BDS study, 2018 Parker, NBDPS study, 2018 Anderka, 2012 3 Tags Adjustment   - No  - No 1.02[0.82; 1.27]1,64390,6310%NAHuybrechts (Unexposed control), 2018 Fejzo (Unexposed control, disease free), 2016 Pasternak, 2013 3   - Yes  - Yes 1.04[0.80; 1.35]2,9421,60715%NAZambelli-Weiner (Unexposed control, NOS), 2019 Parker, BDS study, 2018 Parker, NBDPS study, 2018 Anderka, 2012 4 All studiesAll studies 1.03[0.88; 1.21]4,58592,2380%NAZambelli-Weiner (Unexposed control, NOS), 2019 Huybrechts (Unexposed control), 2018 Parker, BDS study, 2018 Parker, NBDPS study, 2018 Fejzo (Unexposed control, disease free), 2016 Pasternak, 2013 Anderka, 2012 70.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.92.91.4710.000Zambelli-Weiner (Unexposed control, NOS), 2019Huybrechts (Unexposed control), 2018Parker, BDS study, 2018Parker, NBDPS study, 2018Fejzo (Unexposed control, disease free), 2016Pasternak, 2013Anderka, 2012

Asymetry test p-value = 0.9986 (by Egger's regression)

slope=0.0289 (0.1230); intercept=0.0010 (0.5736); t=0.0018; p=0.9986

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 2778, 2852

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.07[0.87; 1.32]2,34791,5170%NAZambelli-Weiner (Unexposed control, NOS), 2019 Huybrechts (Unexposed control), 2018 Fejzo (Unexposed control, disease free), 2016 Pasternak, 2013 4 unexposed, sick controlsunexposed, sick controls 0.98[0.77; 1.25]2,2387210%NAParker, BDS study, 2018 Parker, NBDPS study, 2018 Anderka, 2012 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.93[0.68; 1.27]23156,5310%NAHuybrechts (Control exposed to other treatment), 2018 Fejzo (Mainly exposed to other treatements, sick), 2016 20.510.01.0