Background: Nonreported and selectively reported information and the use of different definitions may introduce biases in the literature of prognostic factors. We probed these biases in a meta-analysis of a prognostic factor for head and neck squamous cell cancer (HNSCC) mortality that has drawn wide attention--the status of the tumor suppressor protein TP53 VSports手机版. .

Methods: We compared results of meta-analyses that included published data plus unpublished data retrieved from investigators; published data; and only published data indexed with "survival" or "mortality" in MEDLINE/EMBASE, with or without standardized definitions. We also evaluated whether previously published meta-analyses on mortality predictors for various malignancies addressed issues of retrieval and standardized information. All statistical tests were two-sided V体育安卓版. .

Results: For the 18 studies with 1364 patients that included published and indexed data, we obtained a highly statistically significant association between TP53 status and mortality. When we used the definitions preferred by each publication, the association was stronger (risk ratio [RR] = 1. 38, 95% confidence interval [CI] = 1. 13 to 1. 67; P = . 001) than when we standardized definitions (RR = 1. 27, 95% CI = 1. 06 to 1. 53; P = . 011). The addition of 13 studies with 1028 subjects that included published but not indexed data reduced the observed association (RR = 1. 23, 95% CI = 1. 03 to 1. 47; P = . 02). Finally, when we obtained data from investigators (11 studies with 996 patients) and analyzed it with all other data, statistical significance was lost (RR = 1. 16, 95% CI = 0. 99 to 1. 35; P = . 06). Among 18 published meta-analyses of 37 cancer prognostic factors, 13 (72%) did not use standardized definitions and 16 (89%) did not retrieve additional information. V体育ios版.

Conclusions: Selective reporting may spuriously inflate the importance of postulated prognostic factors for various malignancies. We recommend that meta-analyses thereof should maximize retrieval of information and standardize definitions VSports最新版本. .