Research Article: Evaluating the Quality of Research into a Single Prognostic Biomarker: A Systematic Review and Meta-analysis of 83 Studies of C-Reactive Protein in Stable Coronary Artery Disease

Date Published: June 1, 2010

Publisher: Public Library of Science

Author(s): Harry Hemingway, Peter Philipson, Ruoling Chen, Natalie K. Fitzpatrick, Jacqueline Damant, Martin Shipley, Keith R. Abrams, Santiago Moreno, Kate S. L. McAllister, Stephen Palmer, Juan Carlos Kaski, Adam D. Timmis, Aroon D. Hingorani, Fiona Mary Turnbull

Abstract: In a systematic review and meta-analysis of 83 prognostic studies of C-reactive protein in coronary disease, Hemingway and colleagues find substantial biases, preventing them from drawing clear conclusions relating to the use of this marker in clinical practice.

Partial Text: In one of the largest (83 studies reporting over 61,000 patients) and most detailed, to our knowledge, evaluations of a single prognostic biomarker, we found the absence of prespecified statistical analytic protocols, publication bias so marked that it could potentially explain much of the association, and multiple types of reporting biases. These biases preclude firm conclusions about the magnitude and independence of the association between higher CRP levels and higher risk of subsequent death and nonfatal cardiovascular events. Taken together with evidence of biases in prognostic biomarker research in cancer [4],[5],[29], stroke [30], trauma [31], and musculoskeletal disorders [32],[33], there is a case for changing the way this type of research is designed and reported.



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