Proton Pump Inhibitors updated on 08-09-2023

Hypospadias

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.
S14453
R57355		 Choi a, 2023 Hypospadias 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes 0.77 [0.51;1.17] 25/20,900   1,799/1,371,387 1,824 20,900
ref
S4357
R10233		 Anderka, 2012 Hypospadias 1st trimester case control unexposed, sick Adjustment: Yes 4.36 [1.21;15.81] 7/12   648/2,599 655 12
ref
S4275
R10702		 Pasternak, 2010 Hypospadia 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 1.55 [0.89;2.70] 14/3,651   -/- - 3,651
ref
S4861
R12563		 Ruigomez - Omeprazole (Controls exposed to other treatment, sick), 1999 Hypospadias 1st trimester retrospective cohort exposed to other treatment, sick excluded Adjustment: No 0.82 [0.04;17.08] C
excluded (control group) 		0/139   2/567 2 139
ref
S4276
R9978		 Ruigomez - Omeprazole (Controls unexposed NOS), 1999 Hypospadias 1st trimester retrospective cohort unexposed (general population or NOS) Adjustment: No 3.79 [0.15;93.41] C 0/139   1/1,575 1 139
ref
S4431
R10751		 Källèn, 1998 Hypospadias 1st trimester population based cohort retrospective exposed to other treatment, sick Adjustment: No 0.23 [0.01;5.68] C 0/275   1/191 1 275
ref
Total 5 studies 1.37 [0.67;2.79] 2,481 24,977
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 Choi a, 2023Choi a, 2023 0.77[0.51; 1.17]1,82420,90038%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: unclearROB mesure: NAROB reporting: NA Anderka, 2012Anderka, 2012 4.36[1.21; 15.81]6551218%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Pasternak, 2010Pasternak, 2010 1.55[0.89; 2.70]-3,65135%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Ruigomez - Omeprazole (Controls unexposed NOS), 1999Ruigomez - Omeprazole, 1999 1 3.79[0.15; 93.41]11394%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Källèn, 1998Källèn, 1998 0.23[0.01; 5.68]12754%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (5 studies) I2 = 61% 1.37[0.67; 2.79]2,48124,9770.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.05[0.58; 1.91]1,82624,96544%NAChoi a, 2023 Pasternak, 2010 Ruigomez - Omeprazole (Controls unexposed NOS), 1999 Källèn, 1998 4 case control studiescase control studies 4.36[1.21; 15.76]65512 -NAAnderka, 2012 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.59[0.92; 2.75]13,7900%NAPasternak, 2010 Ruigomez - Omeprazole (Controls unexposed NOS), 1999 2 unexposed, sickunexposed, sick 1.64[0.30; 8.84]2,47920,91284%NAChoi a, 2023 Anderka, 2012 2 exposed to other treatment, sickexposed to other treatment, sick 0.23[0.01; 5.68]1275 -NAKällèn, 1998 1 Tags Adjustment   - No  - No 0.93[0.06; 14.53]241432%NARuigomez - Omeprazole (Controls unexposed NOS), 1999 Källèn, 1998 2   - Yes  - Yes 1.44[0.65; 3.17]2,47924,56377%NAChoi a, 2023 Anderka, 2012 Pasternak, 2010 3 All studiesAll studies 1.37[0.67; 2.79]2,48124,97761%NAChoi a, 2023 Anderka, 2012 Pasternak, 2010 Ruigomez - Omeprazole (Controls unexposed NOS), 1999 Källèn, 1998 50.110.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.84.21.9630.000Choi a, 2023Anderka, 2012Pasternak, 2010Ruigomez - Omeprazole (Controls unexposed NOS), 1999Källèn, 1998

Asymetry test p-value = 0.5362 (by Egger's regression)

slope=-0.1783 (0.4632); intercept=0.8875 (1.2741); t=0.6966; p=0.5362

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 4861

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.59[0.92; 2.75]63,7900%NAPasternak, 2010 Ruigomez - Omeprazole (Controls unexposed NOS), 1999 2 unexposed, sick controlsunexposed, sick controls 1.64[0.30; 8.84]2,47920,91284%NAChoi a, 2023 Anderka, 2012 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls Out of scale0.45[0.05; 4.07]34140%NARuigomez - Omeprazole (Controls exposed to other treatment, sick), 1999 Källèn, 1998 20.510.01.0