How to use a subgroup analysis: users' guide to the medical literature - PubMed (original) (raw)
How to use a subgroup analysis: users' guide to the medical literature
Xin Sun et al. JAMA. 2014 Jan.
Abstract
Clinicians, when trying to apply trial results to patient care, need to individualize patient care and, potentially, manage patients based on results of subgroup analyses. Apparently compelling subgroup effects often prove spurious, and guidance is needed to differentiate credible from less credible subgroup claims. We therefore provide 5 criteria to use when assessing the validity of subgroup analyses: (1) Can chance explain the apparent subgroup effect; (2) Is the effect consistent across studies; (3) Was the subgroup hypothesis one of a small number of hypotheses developed a priori with direction specified; (4) Is there strong preexisting biological support; and (5) Is the evidence supporting the effect based on within- or between-study comparisons. The first 4 criteria are applicable to individual studies or systematic reviews, the last only to systematic reviews of multiple studies. These criteria will help clinicians deciding whether to use subgroup analyses to guide their patient care.
Comment in
- Absolute vs. relative effects-implications for subgroup analyses.
Andersen LW. Andersen LW. Trials. 2021 Jan 11;22(1):50. doi: 10.1186/s13063-020-05005-7. Trials. 2021. PMID: 33430925 Free PMC article. No abstract available.
Similar articles
- Credibility of claims of subgroup effects in randomised controlled trials: systematic review.
Sun X, Briel M, Busse JW, You JJ, Akl EA, Mejza F, Bala MM, Bassler D, Mertz D, Diaz-Granados N, Vandvik PO, Malaga G, Srinathan SK, Dahm P, Johnston BC, Alonso-Coello P, Hassouneh B, Walter SD, Heels-Ansdell D, Bhatnagar N, Altman DG, Guyatt GH. Sun X, et al. BMJ. 2012 Mar 15;344:e1553. doi: 10.1136/bmj.e1553. BMJ. 2012. PMID: 22422832 Review. - A consumer's guide to subgroup analyses.
Oxman AD, Guyatt GH. Oxman AD, et al. Ann Intern Med. 1992 Jan 1;116(1):78-84. doi: 10.7326/0003-4819-116-1-78. Ann Intern Med. 1992. PMID: 1530753 - A statistical primer on subgroup analyses.
Milojevic M, Nikolic A, Jüni P, Head SJ. Milojevic M, et al. Interact Cardiovasc Thorac Surg. 2020 Jun 1;30(6):839-845. doi: 10.1093/icvts/ivaa042. Interact Cardiovasc Thorac Surg. 2020. PMID: 32215640 Review. - Subgroup analyses in randomised controlled trials: quantifying the risks of false-positives and false-negatives.
Brookes ST, Whitley E, Peters TJ, Mulheran PA, Egger M, Davey Smith G. Brookes ST, et al. Health Technol Assess. 2001;5(33):1-56. doi: 10.3310/hta5330. Health Technol Assess. 2001. PMID: 11701102 Review.
Cited by
- Evidence synthesis of medical cannabis research: current challenges and opportunities.
Senator B, Pardal M, Vandam L. Senator B, et al. Eur Arch Psychiatry Clin Neurosci. 2024 Nov 9. doi: 10.1007/s00406-024-01893-x. Online ahead of print. Eur Arch Psychiatry Clin Neurosci. 2024. PMID: 39516285 - Bias in medical AI: Implications for clinical decision-making.
Cross JL, Choma MA, Onofrey JA. Cross JL, et al. PLOS Digit Health. 2024 Nov 7;3(11):e0000651. doi: 10.1371/journal.pdig.0000651. eCollection 2024 Nov. PLOS Digit Health. 2024. PMID: 39509461 Free PMC article. Review. - Half the price, twice the gain: How to simultaneously decrease animal numbers and increase precision with good experimental design.
Grüninger SL, Frommlet F. Grüninger SL, et al. Lab Anim. 2024 Oct;58(5):411-418. doi: 10.1177/00236772241260905. Epub 2024 Sep 24. Lab Anim. 2024. PMID: 39315538 Free PMC article. - Effectiveness and safety of Arecae Semen compounds for patients with depression: a systematic review and meta-analysis.
Lin T, Zang X, Chen Y, Zhao L, Zhang Y. Lin T, et al. Syst Rev. 2024 Sep 19;13(1):238. doi: 10.1186/s13643-024-02656-4. Syst Rev. 2024. PMID: 39300549 Free PMC article. - Exploring the prevalence of childhood adversity among university students in the United Kingdom: A systematic review and meta-analysis.
Hamilton J, Welham A, Morgan G, Jones C. Hamilton J, et al. PLoS One. 2024 Aug 28;19(8):e0308038. doi: 10.1371/journal.pone.0308038. eCollection 2024. PLoS One. 2024. PMID: 39196983 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources