Impact of Risk of Generalizability Biases in Adult Obesity Interventions: A meta-epidemiological review and meta-analysis
von Klinggraeff, L
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Beets, M., von Klinggraeff, L., Burkat, S., Jones, A., Ioannidis, J., Weaver, R., Okely, A., et al. Impact of Risk of Generalizability Biases in Adult Obesity Interventions: A meta-epidemiological review and meta-analysis. Obesity Reviews https://doi.org/10.17863/CAM.76106
Biases introduced in early-stage studies can lead to inflated early discoveries. The Risk of Generalizability Biases (RGBs) identifies key features of feasibility studies that, when present, lead to reduced impact in a larger trial. This meta-study examined the influence of RGBs in adult obesity interventions. Behavioral interventions with a published feasibility study and a larger-scale trial of the same intervention (e.g., pairs) were identified. Each pair was coded for the presence of RGBs. Quantitative outcomes were extracted. Multi-level meta-regression models were used to examine the impact of RGBs on the difference in the effect size (ES, standardized mean difference) from pilot to larger-scale trial. A total of 114 pairs, representing 230 studies, were identified. Overall, 75% of the pairs had at least one RGB present. The four most prevalent RGBs were duration (33%), delivery agent (30%), implementation support (23%), and target audience (22%) bias. The largest reductions in the ES were observed in pairs where an RGB was present in the pilot and removed in the larger-scale trial (average reduction ES -0.41, range -1.06 to 0.01), compared to pairs without an RGB (average reduction ES -0.15, range -0.18 to -0.14). Eliminating RGBs during early-stage testing may result in improved evidence.
Research reported in this abstract was supported by The National Heart, Lung, and Blood Institute of the National Institutes of Health under award number R01HL149141 (Beets), F31HL158016 (von Klinggraeff), F32HL154530 (Burkart) as well as by the Institutional Development Award (IDeA) from the National Institute of General Medical Sciences of the National Institutes of Health under award number P20GM130420 for the Research Center for Child Well-Being. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Dr. Lubans is supported by a National Health and Medical Research Council Senior Research Fellowship (APP1154507). Dr. Okely is supported by a National Health and Medical Research Council Investigator Grant (APP1176858). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The work of John Ioannidis is supported by an unrestricted gift from Sue and Bob O’Donnell.
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This record's DOI: https://doi.org/10.17863/CAM.76106
This record's URL: https://www.repository.cam.ac.uk/handle/1810/328656
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