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On the basis of our assessment of the literature and the anticipated direction of bias to the null, we believe that unmeasured and incompletely measured confounders are unlikely to affect the substantive conclusions of this IPD meta-analysis, which found associations between current nsaid use and.
That we were able to draw conclusions on the risk of myocardial infarction of nsaid dose levels and treatment durations corresponding to various scenarios of actual use is a novel contribution.The risk of myocardial infarction with celecoxib was not found to exceed that of other nsaids and was lower than for rofecoxib.Terms of Use, privacy Statement.73 Since methods exist for pooling IPD and aggregate data 51 we considered performing a combined IPD aggregate data meta-analysis.Arrivals, view real-time arrivals at your airport.The key advantages of this IPD meta-analysis are its pertinence of populations, power owing to sample size, relevance of exposure measurement, and posterior probability distributions that directly inform clinical practice.4 A weighted average of the IPD meta-analysis findings across the five categories of current rofecoxib use (see table 2 and fig 2 ) would yield a lower risk than that of the approve trial and the Trelle network meta-analysis of randomised controlled only naughty adults trials.In our experience, a particular and possibly underappreciated hurdle of IPD meta-analysis sourced from healthcare databases is that they critically depend on health authorities granting permission to access IPD.Edgar is a federally registered trademark of the.S.By studying 61 460 myocardial infarction events in real world use of nsaids, we found that current use of a nsaid is associated with a significantly increased risk of acute myocardial infarction.The risk of myocardial infarction was not considered separately for the various selective COX 2 inhibitors in the IPD network meta-analysis of randomised controlled trials.
Figs 2 to 6 in web appendix 1 show that the unavailability of four studies did not result in bias.
Comparison with other studies The patients enrolled in the precision randomised controlled trial required regular daily nsaid treatment for arthritis and received rather high doses of ibuprofen (2045 (SD 246) mg) and naproxen (852 (103) mg).