A new tool to assess Clinical Diversity In Meta-analyses (CDIM) of interventions

Marija Barbateskovic; Thijs M Koster; Ruben J Eck; Mathias Maagaard; Arash Afshari; Fredrike Blokzijl; Maria Cronhjort; Willem Dieperink; Maria L Fabritius; Josh Feinberg; Craig French; Barzi Gareb; Anja Geisler; Anders Granholm; Bart Hiemstra; Ruixue Hu; Georgina Imberger; Bente T Jensen; Andreas B Jonsson; Oliver Karam; De Zhao Kong; Steven K Korang; Geert Koster; Baoyong Lai; Ning Liang; Lars H Lundstrøm; Søren Marker; Tine S Meyhoff; Emil E Nielsen; Anders K Nørskov; Marie W Munch; Emilie C Risom; Sofie L Rygård; Sanam Safi; Naqash Sethi; Fredrik Sjövall; Susanne V Lauridsen; Nico van Bakelen; Meint Volbeda; Iwan C C van der Horst; Christian Gluud; Anders Perner; Morten H Møller; Eric Keus; Jørn Wetterslev

doi:10.1016/j.jclinepi.2021.01.023

A new tool to assess Clinical Diversity In Meta-analyses (CDIM) of interventions

Marija Barbateskovic
, Thijs M Koster
, Ruben J Eck
, Mathias Maagaard
, Arash Afshari
, Fredrike Blokzijl
, Maria Cronhjort
, Willem Dieperink
, Maria L Fabritius
, Josh Feinberg
, Craig French
, Barzi Gareb
, Anja Geisler
, Anders Granholm
, Bart Hiemstra
, Ruixue Hu
, Georgina Imberger
, Bente T Jensen
, Andreas B Jonsson
, Oliver Karam

De Zhao Kong, Steven K Korang, Geert Koster, Baoyong Lai, Ning Liang, Lars H Lundstrøm, Søren Marker, Tine S Meyhoff, Emil E Nielsen, Anders K Nørskov, Marie W Munch, Emilie C Risom, Sofie L Rygård, Sanam Safi, Naqash Sethi, Fredrik Sjövall, Susanne V Lauridsen, Nico van Bakelen, Meint Volbeda, Iwan C C van der Horst, Christian Gluud, Anders Perner, Morten H Møller, Eric Keus, Jørn Wetterslev

Danish Dementia Research Centre, Rigshospitalet, Copenhagen University Hospital University of Copenhagen, Copenhagen, Denmark.
University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands; Netherlands Heart Institute, Utrecht, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Clinical and Experimental Cardiology, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen...
Copenhagen Trial Unit (CTU)
Unit of Clinical Therapy Research, Inflammatory Diseases (ClinTRID), Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; Rheumatology Unit, Department of Medicine, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
Department of Anesthesiology and Intensive Care, Holbaek University Hospital, Zealand Region, Denmark.
Melbourne School of Engineering, The University of Melbourne, Melbourne, Australia.
Zealand University Hospital
China Academy of Chinese Medical Sciences
Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Victoria, Australia.
Aarhus University Hospital, Aarhus, Denmark
Children's Hospital of Richmond at VCU
Liaoning University of Traditional Chinese Medicine
Beijing University of Chinese Medicine
Nordsjællands Hospital
Section of Rheumatology, Department of Clinical Sciences, Lund University, Lund, Orthopedics, Department of Clinical Sciences, Lund University, Lund, Sweden.
Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands; Department of Clinical Epidemiology and Medical Technology Assessment, School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands.

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVE: To develop and validate Clinical Diversity In Meta-analyses (CDIM), a new tool for assessing clinical diversity between trials in meta-analyses of interventions.

STUDY DESIGN AND SETTING: The development of CDIM was based on consensus work informed by empirical literature and expertise. We drafted the CDIM tool, refined it, and validated CDIM for interrater scale reliability and agreement in three groups.

RESULTS: CDIM measures clinical diversity on a scale that includes four domains with 11 items overall: setting (time of conduct/country development status/units type); population (age, sex, patient inclusion criteria/baseline disease severity, comorbidities); interventions (intervention intensity/strength/duration of intervention, timing, control intervention, cointerventions); and outcome (definition of outcome, timing of outcome assessment). The CDIM is completed in two steps: first two authors independently assess clinical diversity in the four domains. Second, after agreeing upon scores of individual items a consensus score is achieved. Interrater scale reliability and agreement ranged from moderate to almost perfect depending on the type of raters.

CONCLUSION: CDIM is the first tool developed for assessing clinical diversity in meta-analyses of interventions. We found CDIM to be a reliable tool for assessing clinical diversity among trials in meta-analysis.

Original language	English
Pages (from-to)	29-41
Number of pages	13
Journal	Journal of clinical epidemiology
Volume	135
DOIs	https://doi.org/10.1016/j.jclinepi.2021.01.023
Publication status	Published - Jul 2021

Keywords

Bias
Humans
Meta-Analysis as Topic
Reproducibility of Results
Research Design/statistics & numerical data
Heterogeneity
Quality
Diversity
Evidence
Systematic review
Meta-analysis
Tool

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Barbateskovic, M., Koster, T. M., Eck, R. J., Maagaard, M., Afshari, A., Blokzijl, F., Cronhjort, M., Dieperink, W., Fabritius, M. L., Feinberg, J., French, C., Gareb, B., Geisler, A., Granholm, A., Hiemstra, B., Hu, R., Imberger, G., Jensen, B. T., Jonsson, A. B., ... Wetterslev, J. (2021). A new tool to assess Clinical Diversity In Meta-analyses (CDIM) of interventions. Journal of clinical epidemiology, 135, 29-41. https://doi.org/10.1016/j.jclinepi.2021.01.023

@article{d921bb65562040e2b41b0464ede02e11,

title = "A new tool to assess Clinical Diversity In Meta-analyses (CDIM) of interventions",

abstract = "OBJECTIVE: To develop and validate Clinical Diversity In Meta-analyses (CDIM), a new tool for assessing clinical diversity between trials in meta-analyses of interventions.STUDY DESIGN AND SETTING: The development of CDIM was based on consensus work informed by empirical literature and expertise. We drafted the CDIM tool, refined it, and validated CDIM for interrater scale reliability and agreement in three groups.RESULTS: CDIM measures clinical diversity on a scale that includes four domains with 11 items overall: setting (time of conduct/country development status/units type); population (age, sex, patient inclusion criteria/baseline disease severity, comorbidities); interventions (intervention intensity/strength/duration of intervention, timing, control intervention, cointerventions); and outcome (definition of outcome, timing of outcome assessment). The CDIM is completed in two steps: first two authors independently assess clinical diversity in the four domains. Second, after agreeing upon scores of individual items a consensus score is achieved. Interrater scale reliability and agreement ranged from moderate to almost perfect depending on the type of raters.CONCLUSION: CDIM is the first tool developed for assessing clinical diversity in meta-analyses of interventions. We found CDIM to be a reliable tool for assessing clinical diversity among trials in meta-analysis.",

keywords = "Bias, Humans, Meta-Analysis as Topic, Reproducibility of Results, Research Design/statistics \& numerical data, Heterogeneity, Quality, Diversity, Evidence, Systematic review, Meta-analysis, Tool",

author = "Marija Barbateskovic and Koster, \{Thijs M\} and Eck, \{Ruben J\} and Mathias Maagaard and Arash Afshari and Fredrike Blokzijl and Maria Cronhjort and Willem Dieperink and Fabritius, \{Maria L\} and Josh Feinberg and Craig French and Barzi Gareb and Anja Geisler and Anders Granholm and Bart Hiemstra and Ruixue Hu and Georgina Imberger and Jensen, \{Bente T\} and Jonsson, \{Andreas B\} and Oliver Karam and Kong, \{De Zhao\} and Korang, \{Steven K\} and Geert Koster and Baoyong Lai and Ning Liang and Lundstr{\o}m, \{Lars H\} and S{\o}ren Marker and Meyhoff, \{Tine S\} and Nielsen, \{Emil E\} and N{\o}rskov, \{Anders K\} and Munch, \{Marie W\} and Risom, \{Emilie C\} and Ryg{\aa}rd, \{Sofie L\} and Sanam Safi and Naqash Sethi and Fredrik Sj{\"o}vall and Lauridsen, \{Susanne V\} and \{van Bakelen\}, Nico and Meint Volbeda and \{van der Horst\}, \{Iwan C C\} and Christian Gluud and Anders Perner and M{\o}ller, \{Morten H\} and Eric Keus and J{\o}rn Wetterslev",

note = "Funding Information: Conflict of interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi\_disclosure.pdf and declare: MB and JW report grants from Innovation Fund Denmark during the conduct of the study. TSM reports grants from the Novo Nordisk Foundation and grants from Sofus Friis Foundation outside the submitted work. AP reports two grants from the Novo Nordisk Foundation related to intensive care research. The authors report no other relationships or activities that could appear to have influenced the submitted work. Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. MB's and JW's contribution to this work, was supported by Innovation Fund Denmark [grant number 4108-00011B ]. Publisher Copyright: {\textcopyright} 2021 Elsevier Inc.",

year = "2021",

month = jul,

doi = "10.1016/j.jclinepi.2021.01.023",

language = "English",

volume = "135",

pages = "29--41",

journal = "Journal of clinical epidemiology",

issn = "0895-4356",

publisher = "Elsevier USA",

}

Barbateskovic, M, Koster, TM, Eck, RJ, Maagaard, M, Afshari, A, Blokzijl, F, Cronhjort, M, Dieperink, W, Fabritius, ML, Feinberg, J, French, C, Gareb, B, Geisler, A, Granholm, A, Hiemstra, B, Hu, R, Imberger, G, Jensen, BT, Jonsson, AB, Karam, O, Kong, DZ, Korang, SK, Koster, G, Lai, B, Liang, N, Lundstrøm, LH, Marker, S, Meyhoff, TS, Nielsen, EE, Nørskov, AK, Munch, MW, Risom, EC, Rygård, SL, Safi, S, Sethi, N, Sjövall, F, Lauridsen, SV, van Bakelen, N, Volbeda, M, van der Horst, ICC, Gluud, C, Perner, A, Møller, MH, Keus, E & Wetterslev, J 2021, 'A new tool to assess Clinical Diversity In Meta-analyses (CDIM) of interventions', Journal of clinical epidemiology, vol. 135, pp. 29-41. https://doi.org/10.1016/j.jclinepi.2021.01.023

TY - JOUR

T1 - A new tool to assess Clinical Diversity In Meta-analyses (CDIM) of interventions

AU - Barbateskovic, Marija

AU - Koster, Thijs M

AU - Eck, Ruben J

AU - Maagaard, Mathias

AU - Afshari, Arash

AU - Blokzijl, Fredrike

AU - Cronhjort, Maria

AU - Dieperink, Willem

AU - Fabritius, Maria L

AU - Feinberg, Josh

AU - French, Craig

AU - Gareb, Barzi

AU - Geisler, Anja

AU - Granholm, Anders

AU - Hiemstra, Bart

AU - Hu, Ruixue

AU - Imberger, Georgina

AU - Jensen, Bente T

AU - Jonsson, Andreas B

AU - Karam, Oliver

AU - Kong, De Zhao

AU - Korang, Steven K

AU - Koster, Geert

AU - Lai, Baoyong

AU - Liang, Ning

AU - Lundstrøm, Lars H

AU - Marker, Søren

AU - Meyhoff, Tine S

AU - Nielsen, Emil E

AU - Nørskov, Anders K

AU - Munch, Marie W

AU - Risom, Emilie C

AU - Rygård, Sofie L

AU - Safi, Sanam

AU - Sethi, Naqash

AU - Sjövall, Fredrik

AU - Lauridsen, Susanne V

AU - van Bakelen, Nico

AU - Volbeda, Meint

AU - van der Horst, Iwan C C

AU - Gluud, Christian

AU - Perner, Anders

AU - Møller, Morten H

AU - Keus, Eric

AU - Wetterslev, Jørn

N1 - Funding Information: Conflict of interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: MB and JW report grants from Innovation Fund Denmark during the conduct of the study. TSM reports grants from the Novo Nordisk Foundation and grants from Sofus Friis Foundation outside the submitted work. AP reports two grants from the Novo Nordisk Foundation related to intensive care research. The authors report no other relationships or activities that could appear to have influenced the submitted work. Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. MB's and JW's contribution to this work, was supported by Innovation Fund Denmark [grant number 4108-00011B ]. Publisher Copyright: © 2021 Elsevier Inc.

PY - 2021/7

Y1 - 2021/7

N2 - OBJECTIVE: To develop and validate Clinical Diversity In Meta-analyses (CDIM), a new tool for assessing clinical diversity between trials in meta-analyses of interventions.STUDY DESIGN AND SETTING: The development of CDIM was based on consensus work informed by empirical literature and expertise. We drafted the CDIM tool, refined it, and validated CDIM for interrater scale reliability and agreement in three groups.RESULTS: CDIM measures clinical diversity on a scale that includes four domains with 11 items overall: setting (time of conduct/country development status/units type); population (age, sex, patient inclusion criteria/baseline disease severity, comorbidities); interventions (intervention intensity/strength/duration of intervention, timing, control intervention, cointerventions); and outcome (definition of outcome, timing of outcome assessment). The CDIM is completed in two steps: first two authors independently assess clinical diversity in the four domains. Second, after agreeing upon scores of individual items a consensus score is achieved. Interrater scale reliability and agreement ranged from moderate to almost perfect depending on the type of raters.CONCLUSION: CDIM is the first tool developed for assessing clinical diversity in meta-analyses of interventions. We found CDIM to be a reliable tool for assessing clinical diversity among trials in meta-analysis.

AB - OBJECTIVE: To develop and validate Clinical Diversity In Meta-analyses (CDIM), a new tool for assessing clinical diversity between trials in meta-analyses of interventions.STUDY DESIGN AND SETTING: The development of CDIM was based on consensus work informed by empirical literature and expertise. We drafted the CDIM tool, refined it, and validated CDIM for interrater scale reliability and agreement in three groups.RESULTS: CDIM measures clinical diversity on a scale that includes four domains with 11 items overall: setting (time of conduct/country development status/units type); population (age, sex, patient inclusion criteria/baseline disease severity, comorbidities); interventions (intervention intensity/strength/duration of intervention, timing, control intervention, cointerventions); and outcome (definition of outcome, timing of outcome assessment). The CDIM is completed in two steps: first two authors independently assess clinical diversity in the four domains. Second, after agreeing upon scores of individual items a consensus score is achieved. Interrater scale reliability and agreement ranged from moderate to almost perfect depending on the type of raters.CONCLUSION: CDIM is the first tool developed for assessing clinical diversity in meta-analyses of interventions. We found CDIM to be a reliable tool for assessing clinical diversity among trials in meta-analysis.

KW - Bias

KW - Humans

KW - Meta-Analysis as Topic

KW - Reproducibility of Results

KW - Research Design/statistics & numerical data

KW - Heterogeneity

KW - Quality

KW - Diversity

KW - Evidence

KW - Systematic review

KW - Meta-analysis

KW - Tool

UR - https://www.scopus.com/pages/publications/85102038804

U2 - 10.1016/j.jclinepi.2021.01.023

DO - 10.1016/j.jclinepi.2021.01.023

M3 - Article

SN - 0895-4356

VL - 135

SP - 29

EP - 41

JO - Journal of clinical epidemiology

JF - Journal of clinical epidemiology

ER -

A new tool to assess Clinical Diversity In Meta-analyses (CDIM) of interventions

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Keywords

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