Conclusions in systematic reviews of mammography for breast cancer screening and associations with review design and author characteristics

Smriti Raichand, Adam G. Dunn, Mei Sing Ong, Florence T. Bourgeois, Enrico Coiera, Kenneth D. Mandl

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Debates about the benefits and harms of mammography continue despite the accumulation of evidence. We sought to quantify the disagreement across systematic reviews of mammography and determine whether author or design characteristics were associated with conclusions that were favourable to the use of mammography for routine breast cancer screening. Methods: We identified systematic reviews of mammography published between January 2000 and November 2015, and extracted information about the selection of evidence, age groups, the use of meta-analysis, and authors' professions and financial competing interest disclosures. Conclusions about specific age groups were graded as favourable if they stated that there were meaningful benefits, that benefits of mammography outweighed harms, or that harms were inconsequential. The main outcome measures were the proportions of favourable conclusions relative to review design and author characteristics. Results: From 59 conclusions identified in 50 reviews, 42% (25/59) were graded as favourable by two investigators. Among the conclusions produced by clinicians, 63% (12/19) were graded as favourable compared to 32% (13/40) from other authors. In the 50-69 age group where the largest proportion of systematic reviews were focused, conclusions drawn by authors without financial competing interests (odds ratio 0.06; 95% CI 0.07-0.56) and non-clinicians (odds ratio 0.11; 95% CI 0.01-0.84) were less likely to be graded as favourable. There was no trend in the proportion of favourable conclusions over the period, and we found no significant association between review design characteristics and favourable conclusions. Conclusions: Differences in the conclusions of systematic reviews of the evidence for mammography have persisted for 15 years. We found no strong evidence that design characteristics were associated with greater support for the benefits of mammography in routine breast cancer screening. Instead, the results suggested that the specific expertise and competing interests of the authors influenced the conclusions of systematic reviews.

LanguageEnglish
Article number105
Pages1-8
Number of pages8
JournalSystematic Reviews
Volume6
Issue number1
DOIs
Publication statusPublished - 22 May 2017

Fingerprint

Mammography
Early Detection of Cancer
Breast Neoplasms
Age Groups
Odds Ratio
Disclosure
Meta-Analysis
Research Personnel
Outcome Assessment (Health Care)

Bibliographical note

Copyright the Author(s) 2017. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • Bias
  • Breast cancer
  • Competing interests
  • Mammography screening
  • Systematic reviews as topic

Cite this

@article{6eb7611a21a2484b8988c6b2dc42db3d,
title = "Conclusions in systematic reviews of mammography for breast cancer screening and associations with review design and author characteristics",
abstract = "Background: Debates about the benefits and harms of mammography continue despite the accumulation of evidence. We sought to quantify the disagreement across systematic reviews of mammography and determine whether author or design characteristics were associated with conclusions that were favourable to the use of mammography for routine breast cancer screening. Methods: We identified systematic reviews of mammography published between January 2000 and November 2015, and extracted information about the selection of evidence, age groups, the use of meta-analysis, and authors' professions and financial competing interest disclosures. Conclusions about specific age groups were graded as favourable if they stated that there were meaningful benefits, that benefits of mammography outweighed harms, or that harms were inconsequential. The main outcome measures were the proportions of favourable conclusions relative to review design and author characteristics. Results: From 59 conclusions identified in 50 reviews, 42{\%} (25/59) were graded as favourable by two investigators. Among the conclusions produced by clinicians, 63{\%} (12/19) were graded as favourable compared to 32{\%} (13/40) from other authors. In the 50-69 age group where the largest proportion of systematic reviews were focused, conclusions drawn by authors without financial competing interests (odds ratio 0.06; 95{\%} CI 0.07-0.56) and non-clinicians (odds ratio 0.11; 95{\%} CI 0.01-0.84) were less likely to be graded as favourable. There was no trend in the proportion of favourable conclusions over the period, and we found no significant association between review design characteristics and favourable conclusions. Conclusions: Differences in the conclusions of systematic reviews of the evidence for mammography have persisted for 15 years. We found no strong evidence that design characteristics were associated with greater support for the benefits of mammography in routine breast cancer screening. Instead, the results suggested that the specific expertise and competing interests of the authors influenced the conclusions of systematic reviews.",
keywords = "Bias, Breast cancer, Competing interests, Mammography screening, Systematic reviews as topic",
author = "Smriti Raichand and Dunn, {Adam G.} and Ong, {Mei Sing} and Bourgeois, {Florence T.} and Enrico Coiera and Mandl, {Kenneth D.}",
note = "Copyright the Author(s) 2017. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",
year = "2017",
month = "5",
day = "22",
doi = "10.1186/s13643-017-0495-6",
language = "English",
volume = "6",
pages = "1--8",
journal = "Systematic Reviews",
issn = "2046-4053",
publisher = "Springer, Springer Nature",
number = "1",

}

Conclusions in systematic reviews of mammography for breast cancer screening and associations with review design and author characteristics. / Raichand, Smriti; Dunn, Adam G.; Ong, Mei Sing; Bourgeois, Florence T.; Coiera, Enrico; Mandl, Kenneth D.

In: Systematic Reviews, Vol. 6, No. 1, 105, 22.05.2017, p. 1-8.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Conclusions in systematic reviews of mammography for breast cancer screening and associations with review design and author characteristics

AU - Raichand, Smriti

AU - Dunn, Adam G.

AU - Ong, Mei Sing

AU - Bourgeois, Florence T.

AU - Coiera, Enrico

AU - Mandl, Kenneth D.

N1 - Copyright the Author(s) 2017. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2017/5/22

Y1 - 2017/5/22

N2 - Background: Debates about the benefits and harms of mammography continue despite the accumulation of evidence. We sought to quantify the disagreement across systematic reviews of mammography and determine whether author or design characteristics were associated with conclusions that were favourable to the use of mammography for routine breast cancer screening. Methods: We identified systematic reviews of mammography published between January 2000 and November 2015, and extracted information about the selection of evidence, age groups, the use of meta-analysis, and authors' professions and financial competing interest disclosures. Conclusions about specific age groups were graded as favourable if they stated that there were meaningful benefits, that benefits of mammography outweighed harms, or that harms were inconsequential. The main outcome measures were the proportions of favourable conclusions relative to review design and author characteristics. Results: From 59 conclusions identified in 50 reviews, 42% (25/59) were graded as favourable by two investigators. Among the conclusions produced by clinicians, 63% (12/19) were graded as favourable compared to 32% (13/40) from other authors. In the 50-69 age group where the largest proportion of systematic reviews were focused, conclusions drawn by authors without financial competing interests (odds ratio 0.06; 95% CI 0.07-0.56) and non-clinicians (odds ratio 0.11; 95% CI 0.01-0.84) were less likely to be graded as favourable. There was no trend in the proportion of favourable conclusions over the period, and we found no significant association between review design characteristics and favourable conclusions. Conclusions: Differences in the conclusions of systematic reviews of the evidence for mammography have persisted for 15 years. We found no strong evidence that design characteristics were associated with greater support for the benefits of mammography in routine breast cancer screening. Instead, the results suggested that the specific expertise and competing interests of the authors influenced the conclusions of systematic reviews.

AB - Background: Debates about the benefits and harms of mammography continue despite the accumulation of evidence. We sought to quantify the disagreement across systematic reviews of mammography and determine whether author or design characteristics were associated with conclusions that were favourable to the use of mammography for routine breast cancer screening. Methods: We identified systematic reviews of mammography published between January 2000 and November 2015, and extracted information about the selection of evidence, age groups, the use of meta-analysis, and authors' professions and financial competing interest disclosures. Conclusions about specific age groups were graded as favourable if they stated that there were meaningful benefits, that benefits of mammography outweighed harms, or that harms were inconsequential. The main outcome measures were the proportions of favourable conclusions relative to review design and author characteristics. Results: From 59 conclusions identified in 50 reviews, 42% (25/59) were graded as favourable by two investigators. Among the conclusions produced by clinicians, 63% (12/19) were graded as favourable compared to 32% (13/40) from other authors. In the 50-69 age group where the largest proportion of systematic reviews were focused, conclusions drawn by authors without financial competing interests (odds ratio 0.06; 95% CI 0.07-0.56) and non-clinicians (odds ratio 0.11; 95% CI 0.01-0.84) were less likely to be graded as favourable. There was no trend in the proportion of favourable conclusions over the period, and we found no significant association between review design characteristics and favourable conclusions. Conclusions: Differences in the conclusions of systematic reviews of the evidence for mammography have persisted for 15 years. We found no strong evidence that design characteristics were associated with greater support for the benefits of mammography in routine breast cancer screening. Instead, the results suggested that the specific expertise and competing interests of the authors influenced the conclusions of systematic reviews.

KW - Bias

KW - Breast cancer

KW - Competing interests

KW - Mammography screening

KW - Systematic reviews as topic

UR - http://www.scopus.com/inward/record.url?scp=85019944732&partnerID=8YFLogxK

UR - http://purl.org/au-research/grants/nhmrc/1052871

U2 - 10.1186/s13643-017-0495-6

DO - 10.1186/s13643-017-0495-6

M3 - Article

VL - 6

SP - 1

EP - 8

JO - Systematic Reviews

T2 - Systematic Reviews

JF - Systematic Reviews

SN - 2046-4053

IS - 1

M1 - 105

ER -