By Peter Aspelin, Marie France Bellin, Jarl å. Jakobsen, Judith A. W. Webb (auth.), Henrik S. Thomsen MD, Judith A. W. Webb MD, FRCP, FRCR (eds.)
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Extra info for Contrast Media: Safety Issues and ESUR Guidelines
It is also all too common to retrieve only a few studies on a given clinical topic from the literature, or to ﬁnd studies of such low quality that including or even discussing them in the setting of a systematic review may be misleading. This drawback is particularly associated with small study bias, which is a major threat to the validity of meta-analysis (Egger et al. 2001). Especially when datasets are large, small primary studies are more likely to be reported, published and quoted if their results are signiﬁcant.
This applies particularly to the research evidence, which has now accumulated on acetylcysteine for the prevention of CIN (BiondiZoccai et al. 2006), but also to other commonly prescribed agents such as contrast media. 6 Conﬂicts of Interest and Funding Issues Another major threat to the validity of a systematic review, as to any other research project, depends on conﬂicts of interest and how studies are funded. It is well known that reviewers with underlying ﬁnancial conﬂicts of interest are more likely to draw conclusions that favor an intervention, which beneﬁts the source of any ﬁnancial gain (Barnes and Bero 1998).
15% (Ansell et al. 1980; Witten et al. 1973). Mortality with the ionic agents is in the range 1 in 14,000 to 1 in 169,000 (Shehadi 1975; Katayama et al. 1990), with 1 in 75,000 an often quoted ﬁgure (Hartman et al. 1982). With the newer low-osmolality nonionic agents, the reaction rates are lower, by a factor of approximately 4–5 times (Katayama et al.