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  • JAMA July 11, 2017

    Figure 5: Association of Positive Airway Pressure With Vascular Outcomes and Deaths in Trial Subgroups

    Box sizes are proportional to study weight (box center positioned at point estimate of effect). The I2 value indicates the percentage of variability across the pooled estimates attributable to heterogeneity beyond chance (0%-25%, low likelihood; 26%-75%, moderate likelihood; 76%-100%, high likelihood), and the P value is for a test of heterogeneity across all studies. Abbreviations: ASV, adaptive servo-ventilation; CPAP, continuous positive airway pressure; CSA, central sleep apnea; OSA: obstructive sleep apnea; PAP, positive airway pressure.aMajor adverse cardiovascular events comprise cardiovascular death, nonfatal acute coronary syndrome, and nonfatal stroke.bPlus indicates major adverse cardiovascular events in addition to hospitalization for unstable angina.
  • JAMA July 11, 2017

    Figure 2: Meta-analysis of the Association of Positive Airway Pressure With Cardiovascular Events and Death

    Box sizes are proportional to study weight (box center positioned at point estimate of effect). Horizontal lines indicate 95% CIs. The I2 value indicates the percentage of variability across the pooled estimates attributable to heterogeneity beyond chance (0%-25%, low likelihood; 26%-75%. moderate likelihood; 76%-100%, high likelihood), and the P value is for a test of heterogeneity across all studies (P value <.05 indicates likely variation across pooled estimates beyond chance). If 0 events were reported for 1 cell in a comparison, a value of 0.5 was added to both cells automatically before calculating the risk ratio (95% CI). Risk ratio data are rounded to 2 decimal places but plotted to exact values.aMajor adverse cardiovascular events consist of cardiovascular death, nonfatal acute coronary syndrome, and nonfatal stroke.bPlus indicates major adverse cardiovascular events in addition to hospitalization for unstable angina.
  • JAMA July 11, 2017

    Figure 3: Meta-analysis of the Association of Positive Airway Pressure With Cardiovascular Outcomes

    Box sizes are proportional to study weight (box center positioned at point estimate of effect). Horizontal lines indicate 95% CIs. The I2 value indicates the percentage of variability across the pooled estimates attributable to heterogeneity beyond chance (0%-25%, low likelihood; 26%-75%. moderate likelihood; 76%-100%, high likelihood), and the P value is for a test of heterogeneity across all studies (P value <.05 indicates likely variation across pooled estimates beyond chance). If 0 events were reported for 1 cell in a comparison, a value of 0.5 was added to both cells automatically before calculating the risk ratio (95% CI). Risk ratio data are rounded to 2 decimal places but plotted to exact values.
  • JAMA March 7, 2017

    Figure 1: Association of Damaging Lipoprotein Lipase Gene (LPL) Mutations With Circulating Lipid Concentrations

    Beta coefficients reflective of the difference in lipid concentrations between carriers of a damaging LPL mutation and noncarriers were derived from linear regression models that included adjustment for age, age squared, sex, cohort, and the first 5 principal components of ancestry. Principal components of ancestry were based on observed genotypic differences across subpopulations (eg, race or ethnicity) in the overall study. Inclusion of principal components as covariates in linear regression analyses increases statistical power for true relationships and minimizes confounding by ancestry. Fixed-effects meta-analysis was used to combine results across cohorts (P for heterogeneity > .50 for each lipid phenotype). The number of participants from each study cohort with lipid fraction values available is displayed. HDL indicates high-density lipoprotein; IQR, interquartile range; and LDL, low-density lipoprotein. To convert cholesterol to millimoles per liter, multiply by 0.0259; triglycerides to millimoles per liter, multiply by 0.0113.
  • JAMA August 16, 2016

    Figure 2: Clinical Imaging of Aortic Dissection and Intramural Hematoma From Different Patients

    A, Type A aortic dissection, axial contrast enhanced computed tomography (CT) at the level of the pulmonary artery bifurcation (star = false lumen). B, Type B aortic dissection, axial contrast enhanced CT at the level of the carina (star = false lumen). C, Type A aortic dissection, sagittal contrast enhanced CT (arrowhead = dissection plane). D, Type B aortic dissection, sagittal contrast enhanced CT. Note the false lumen along the inner (anterior) curve of the aorta. (arrowhead = dissection plane). E, Type A intramural hematoma, coronal contrast enhanced CT (star = hematoma). F, Type B intramural hematoma, sagittal contrast enhanced CT. Arrowheads point to hematoma within the wall of the descending aorta. Note heterogeneous hyperintensity corresponding to blood.
  • Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis

    Abstract Full Text
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    JAMA. 2016; 315(23):2554-2563. doi: 10.1001/jama.2016.8012

    This meta-analysis of randomized trials examines the effects of plant-based therapies, including phytoestrogens and medicinal herbs, on symptoms of menopause.

  • JAMA June 21, 2016

    Figure 3: Meta-analysis of Randomized Clinical Trials Assessing the Associations Between Use of Red Clover and Black Cohosh and Number of Daily Hot Flashes

    Assessment of heterogeneity: red clover and number of hot flashes in 24 hours, I2 = 97% (95% CI, 95%-98%; P < .001); black cohosh and number of hot flashes: I2 = 60% (95% CI, 0%-89%; P = .08). Sizes of data markers are proportional to the inverse of the variance of the effect estimate. NR indicates not reported.aMean change in the number of hot flashes in 24 hours from randomization to the end of study. bMean difference of changes in the number of hot flashes in 24 hours between treatment groups.
  • JAMA June 21, 2016

    Figure 2: Meta-analysis of Randomized Clinical Trials on the Associations Between Use of Phytoestrogen Supplementation and Menopausal Symptoms

    Phytoestrogens are defined as use of dietary soy isoflavones and supplements and extracts of soy isoflavones, red clover isoflavones, and other phytoestrogens. Sizes of data markers are proportional to the inverse of the variance of the effect estimate. Vaginal dryness score was based on a 4-point scale of severity: 0 = nonexistent, 1 = mild, 2 = moderate, 3 = severe. Assessment of heterogeneity: number of hot flashes in 24 hours, I2 = 94% (95% CI, 92%-98%; P < .001); number of night sweats in 24 hours, I2 = 99% (95% CI, 98%-99%; P < .001); vaginal dryness score, I2 = 48% (95% CI, 0%-85%; P = .15). NR indicates not reported.aMean change in outcome from randomization to the end of study. bMean difference of changes between treatment groups.
  • JAMA May 24, 2016

    Figure 3: Intention-to-Treat Analysis Response Rates for 4 Effectiveness Measures in Subgroups Stratified by Emphysema Distribution and Degree of Air Trapping

    The greatest and most consistent improvements occurred in the residual volume ≥225% subgroups, particularly those with heterogeneous disease. Response rates were calculated with logistic regression with data from the full intention-to-treat analysis set, with multiple imputation. FEV1 indicates forced expiratory volume in the first second.
  • JAMA May 26, 2015

    Figure 1: Association Between Subclinical Hyperthyroidism and Fracture Risk

    Hazard ratios (HRs) were adjusted for age and sex. Data marker sizes are proportional to the inverse of the variance of the HRs. Error bars indicate 95% CIs. Not every outcome was available for each study. Calculations of τ2 were used to measure heterogeneity in effect estimates across cohorts, with a prespecified τ2 (≤0.04) indicating low heterogeneity and greater than 0.04 to 0.36 indicating moderate heterogeneity.
  • Meta-analysis as Evidence: Building a Better Pyramid

    Abstract Full Text
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    JAMA. 2014; 312(6):603-606. doi: 10.1001/jama.2014.8167
  • JAMA August 6, 2014

    Figure 3: Distribution of the CYP2C9*3 Variant in Cases With Phenytoin-Related Severe Cutaneous Adverse Reactions and Population Controls

    Patients with phenytoin-related severe cutaneous adverse reactions were recruited at the Chang Gung Memorial Hospital health system and the Taiwan Severe Cutaneous Adverse Reaction Consortium in Taiwan, Hospital Sultanah Aminah Johor Bahru in Malaysia, and centers collaborating with the National Institute of Health Sciences and Osaka University in Japan. Study weighting (indicated by size of data markers) refers to the proportion of participants who were recruited from each study. The τ2 and I2 represent measures of heterogeneity. Diamonds represent pooled odds ratios (Mantel-Haenszel method, random effects) and error bars indicate 95% CIs. DRESS indicates drug reaction with eosinophilia and systemic symptoms; SJS, Stevens-Johnson syndrome; TEN, toxic epidermal necrolysis.
  • How to Read a Systematic Review and Meta-analysis and Apply the Results to Patient Care: Users’ Guides to the Medical Literature

    Abstract Full Text
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    JAMA. 2014; 312(2):171-179. doi: 10.1001/jama.2014.5559
  • Finding the Missing Link for Big Biomedical Data

    Abstract Full Text
    JAMA. 2014; 311(24):2479-2480. doi: 10.1001/jama.2014.4228
  • JAMA March 26, 2014

    Figure 2: Hazard Ratios for Incident Cardiovascular Disease for Glycemia Measures by Selected Study-Level Characteristics

    Participants with levels of glycemia measures below the mean were excluded. Baseline SD was used to calculate per-SD hazard ratio (HR). Analyses were conducted using studies with information across all levels of each subgroup variable. DCCT indicates Diabetes Control and Complications Trial; HPLC, high-performance liquid chromatography; ITA, immunoturbidimetric assay. A full list of the characteristics examined for heterogeneity is provided in eFigures 5 through 8 in Supplement.
  • JAMA April 3, 2013

    Figure: Rate Ratios (All Falls) for Selected Fall-Prevention Interventions vs Control in Community-Dwelling Older Peoplea

    aBased on data from Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Sys Rev. 2012;(9):CD007146. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007146.pub3/abstract doi:R10.1002/14651858.CD007146.pub3. Absolute numbers for analyses are not provided because the absolute number of falls in each group was not always available. For these analyses, the “absolute number” was a rate of falls, eg, falls per person-year, or in some cases a reported rate ratio. bControl groups received no intervention, usual care, or an intervention that was not expected to reduce falls, eg, social visits. cThe number of trials does not add to 159 because not all of the trials evaluated in the Cochrane review are summarized here. dVariation across the results from individual studies due to clinical and/or statistical diversity. A P value <.10 represents a statistically significant variation. I2 measures the variation in results between studies that is due to heterogeneity rather than sampling error (chance) (range, 0%-100%). eFor people with carotid sinus hypersensitivity and history of syncope and/or falls.
  • The Value of Low-Value Lists

    Abstract Full Text
    JAMA. 2013; 309(8):775-776. doi: 10.1001/jama.2013.828
  • JAMA February 13, 2013

    Figure 1: Meta-analysis of the Risk of Low Birth Weight in Trials Comparing the Standard 2-Dose vs 3 or More Doses of Intermittent Preventive Therapy During Pregnancy With Sulfadoxine-Pyrimethamine

    G1-G2 indicates first and second pregnancies; ≥G3, 2 or more previous pregnancies; HIV, human immunodeficiency virus; RR, relative risk. P values after the I2 statistics represent the χ2 test for heterogeneity. Dersimonian-Laird method used to calculate random-effects models; Mantel-Haenszel for fixed-effects models. Weights are from random-effects analysis. Data marker sizes indicate the weight applied to each study with random-effects meta-analysis. Test for subgroup differences: χ24 = 0.62, P = .96, l2 = 0.0%.
  • JAMA February 13, 2013

    Figure 2: Meta-analysis of Mean Birth Weight in 7 Trials Comparing the Standard 2-Dose vs 3 or More Doses of Intermittent Preventive Therapy During Pregnancy With Sulfadoxine-Pyrimethamine

    G1-G2 indicates first and second pregnancies; ≥G3, 2 or more previous pregnancies; HIV, human immunodeficiency virus status. P values after the I2 statistics represent the χ2 test for heterogeneity. Dersimonian-Laird method used for random-effects models; inverse-variance method used in the fixed-effects models. Weights are from random-effects analysis. Data marker sizes indicate the weight applied to each study with random-effects meta-analysis. Test for subgroup differences: χ24  = 3.14, P = .53, l2 = 0.0%.
  • Improving Population Health in US Cities

    Abstract Full Text
    JAMA. 2013; 309(5):449-450. doi: 10.1001/jama.2012.154302