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Journal ArticleDOI

A consumer's guide to subgroup analyses.

Andrew D Oxman, +1 more
- 01 Jan 1992 - 
- Vol. 116, Iss: 1, pp 78-84
TLDR
Guidelines are provided in this paper that will assist clinicians in making decisions regarding whether to base a treatment decision on overall results or on the results of a subgroup analysis.
Abstract
The extent to which a clinician should believe and act on the results of subgroup analyses of data from randomized trials or meta-analyses is controversial. Guidelines are provided in this paper for making these decisions. The strength of inference regarding a proposed difference in treatment effect among subgroups is dependent on the magnitude of the difference, the statistical significance of the difference, whether the hypothesis preceded or followed the analysis, whether the subgroup analysis was one of a small number of hypotheses tested, whether the difference was suggested by comparisons within or between studies, the consistency of the difference, and the existence of indirect evidence that supports the difference. Application of these guidelines will assist clinicians in making decisions regarding whether to base a treatment decision on overall results or on the results of a subgroup analysis.

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References
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TL;DR: A reasonable standard design and conduct of trials will facilitate the interpretation of those with conflicting results and help in making valid combinations of undersized trials.
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TL;DR: Overall, the reporting of clinical trials appears to be biased toward an exaggeration of treatment differences, and more emphasis should be given to the magnitude of treatment Differences and to estimation methods such as confidence intervals.
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Heart failure in outpatients: a randomized trial of digoxin versus placebo.

TL;DR: It is suggested that long-term digoxin therapy is clinically beneficial in patients with heart failure unaccompanied by atrial fibrillation whose failure persists despite diuretic treatment and who have a third heart sound.
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