Table A1:
QUIPSa Risk of Bias Among Prognostic Studies Assessing the Independent Prognostic Value of MRD for Relapse
| Author, Year | Study Participation | Study Attrition | Prognostic Factor Measurement | Outcome Measurement | Study Confounding | Statistical Analysis and Reporting |
|---|---|---|---|---|---|---|
| Meleshko et al, 201167 | Low | Low | Low | Low | Moderateb | Low |
| Zhou et al, 200770 | Low | Low | Moderatec | Low | Moderatec | Low |
| Laughton et al, 200566 | Low | Low | Low | Low | Moderated | Low |
| Dworzak et al, 200264 | Low | Low | Moderatee | Low | Low | Low |
| Coustan-Smith et al, 200057 | Low | Low | Low | Low | Low | Moderatef |
| Van Dongen et al, 199858 | Low | Low | Low | Low | Moderated | Low |
| Cavé et al, 199856 | Low | Low | Low | Low | Moderateg | Moderated |
| Coustan-Smith et al, 200463 | Low | Low | Low | Low | Low | Low |
| Gandemer et al, 201465 | Low | Low | Low | Low | Low | Low |
| Balduzzi et al, 201461 | Low | Low | Low | Low | Low | Low |
| Bader et al, 200255 | Low | Low | Low | Low | Low | Highh |
Abbreviations: MRD, minimal residual disease; QUIPS, Quality In Prognostic Studies tool.
Each consideration for the study is judged on information within the published article(s) to be at low, moderate, or high risk of bias. Details of QUIPS risk of bias assessment for studies are described in Hayden et al.54
Observed effect of MRD on relapse could be distorted by another factor. Analysis did not adjust for either cytogenetics (owing to low occurrence of adverse cytogenetics) or treatment group, which differed by an additional randomization to one or two cytotoxic agent(s) during induction therapy.
Observed effect of MRD on relapse could be distorted by another factor. Cut-points for MRD positivity used in the analysis were not defined a priori but were data-dependent, derived from recursive partitioning analysis, and cytogenetics were not adjusted for in the analysis.
Observed effect of MRD on relapse could be distorted by another factor, as cytogenetics were not reported to be measured or accounted for in the analysis, so results could be spurious or biased related to analysis or reporting.
A very low proportion (12%) of study participants experienced relapse that likely contributed to width of confidence interval, and 58.3% of study participants had complete data for the prognostic factor variable and were included in the analysis, which might not represent an adequate proportion of the study sample.
No effect estimate, confidence interval, or standard error reported from prognostic analysis (P value only); analysis could have feasibly adjusted for multiple confounders simultaneously but did separate adjustment, and results could be spurious or biased because of analysis or reporting.
Observed effect of MRD on relapse could be distorted by another factor. Data not shown for all analyses in publication. Some could not be acquired, and details were insufficient to include in meta-analysis.
Statistical analysis and variables are poorly described, method of Cox model building is unclear, questionable number of covariates included in model considering sample size, and no effect estimate, confidence interval, or standard error reported from prognostic analysis (P value only), so results could be spurious or biased because of analysis or reporting.