{"id":2497,"date":"2012-02-26T07:32:20","date_gmt":"2012-02-26T12:32:20","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=2497"},"modified":"2015-06-04T15:14:56","modified_gmt":"2015-06-04T19:14:56","slug":"a-truly-bizarre-systematic-review","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/a-truly-bizarre-systematic-review\/2012\/02\/26\/","title":{"rendered":"A Truly Bizarre “Systematic” Review"},"content":{"rendered":"

\"\"<\/a>You know that tenofovir, emtricitabine, and efavirenz HIV regimen? The one that’s universally listed as one of the “Preferred,” or “Recommended” or “First-line” options in all HIV treatment guidelines in the universe?<\/p>\n

And the regimen that is easily the most widely used in the USA today?<\/p>\n

Well, here’s a surprising review from Cochrane Summaries<\/a>, entitled “Effectiveness and safety of first-line tenofovir + emtricitabine + efavirenz for patients with HIV”:<\/p>\n

\n

We searched the Cochrane Central Register of Controlled Trials, EMBASE, GATEWAY, LILACS, PubMed, AEGIS, and the WHO prospective clinical trials registry in November 2011…Only one study<\/strong> [emphasis mine] involving 517 antiretroviral-naive HIV infected adults was included in this review.<\/p><\/blockquote>\n

The authors go on to conclude, “The effects and safety of TDF + FTC + EFV as first-line treatment for patients with HIV cannot be assessed on the basis of only one trial. Further studies evaluating the effects and safety of TDF + FTC + EFV as first-line treatment for patients with HIV are needed.”<\/p>\n

Gosh.<\/p>\n

This is so mind-bogglingly wrong that it’s almost as if the review appeared in the medical version of The Onion<\/a>, if there were such a thing.<\/p>\n

They write<\/em> that their inclusion criteria for this review was “Randomized controlled trials that evaluated the effects and safety of TDF + FTC + EFV compared with other HAART regimens, as first-line treatment for patients with HIV.”<\/p>\n

But maybe they used additional criteria — such as “Only studies published in a calendar year in which the St. Louis Cardinals won the World Series<\/a>, and whose first author’s last name starts with the 7th letter of the alphabet<\/a> will be considered for inclusion”, as the Gilead 934<\/a> study is the only one they chose.<\/p>\n

Because for the record, there’s also this study (5202).<\/a><\/p>\n

And this one (STARTMRK).<\/a><\/p>\n

And this one (ECHO).<\/a><\/p>\n

And this one (THRIVE). <\/a><\/p>\n

And this one (ASSERT).<\/a><\/p>\n

And this one (Altair).<\/a><\/p>\n

And if you want to include TDf + 3TC + EFV (why not), there’s this one (Gilead 903).<\/a><\/p>\n

And this one (5142)…<\/a><\/p>\n

I’m sure I’ve left something out. But you get the idea.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

You know that tenofovir, emtricitabine, and efavirenz HIV regimen? The one that’s universally listed as one of the “Preferred,” or “Recommended” or “First-line” options in all HIV treatment guidelines in the universe? And the regimen that is easily the most widely used in the USA today? Well, here’s a surprising review from Cochrane Summaries, entitled […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,8,10],"tags":[207],"class_list":["post-2497","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","category-patient-care","category-research","tag-cochrane-review"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/2497","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=2497"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/2497\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=2497"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=2497"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=2497"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}