Reason for withdrawal from publication
July 2017
This review is being withdrawn by the Cochrane Review Group with the agreement of the authors, as, at the time of writing, 67 of the 737 studies included in the review have been retracted since the review was published, and there are also investigations ongoing for a number of other studies. Retracted studies and the analyses affected are listed below.
When this Cochrane Review was published there had already been some criticism of the studies authored by Fujii et al., and the authors of the Cochrane Review performed subgroup analyses that compared studies authored by Fujii et al with other studies (comparisons 13.01 to 13.09).
This review will now be split, updated and replaced following the publication of a new protocol ("Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia"). This version will remain withdrawn when the new review is published.
Analyses that include studies that have been retracted: 1.1, 1.2, 1.3, 1.4, 3.1, 3.2, 3.3, 3.4, 4.1, 4.2, 4.3, 4.4, 6.1, 6.2, 6.3, 6.4, 7.2, 7.5, 12.3, 12.8, 12.11, 12.15, 12.18, 12.20, 12.24, 12.27, 12.31, 12.34, 12.39, 12.42, 13.1, 13.2, 13.3, 13.4, 13.5, 13.6, 13.7, 13.8, 13.9.
Studies that have been retracted, listed by study IDs; please see the full text of the review for further information.
Abou Zeid 2002; Fujii 1994; Fujii 1994b; Fujii 1995; Fujii 1995b; Fujii 1996; Fujii 1996b; Fujii 1996c; Fujii 1996d; Fujii 1996e; Fujii 1997; Fujii 1997b; Fujii 1997c; Fujii 1997d; Fujii 1997ev Fujii 1997f; Fujii 1997g; Fujii 1997h; Fujii 1998; Fujii 1998b; Fujii 1998c; Fujii 1998d; Fujii 1998e; Fujii 1998f; Fujii 1998g; Fujii 1998h; Fujii 1998i; Fujii 1998j; Fujii 1998k; Fujii 1998L; Fujii 1998m; Fujii 1998n; Fujii 1998o; Fujii 1998q; Fujii 1998r; Fujii 1998s; Fujii 1998t; Fujii 1998u; Fujii 1999; Fujii 1999b; Fujii 1999c; Fujii 1999d; Fujii 1999e; Fujii 1999f; Fujii 1999g; Fujii 1999h; Fujii 1999i; Fujii 1999j; Fujii 1999k; Fujii 1999L; Fujii 1999m; Fujii 2000; Fujii 2000b; Fujii 2000c; Fujii 2001; Fujii 2001d; Fujii 2001e; Fujii 2001f; Fujii 2001g; Fujii 2002; Fujii 2002b; Fujii 2002e; Fujii 2002f; Fujii 2003; Handa 2001; Piper 2001; Piper 2002.
December 2016
The future of this review is being considered. This is because it includes a large number of retracted studies
The editorial group responsible for this previously published document have withdrawn it from publication.
Feedback
Feedback submitted: 04‐Feb‐2014
Summary
The review is out of date, and needs to be updated with included summary of findings table, and risk of bias figures.
Due to the very large nature of the topic, it is very difficult to find specific information from the review. Perhaps dividing it into smaller more specific reviews would allow scientific questions to be more easily answered, and would also allow a shorter time to update each review.
In terms of outcomes, we do not see the clinical utility of having separate analyses for nausea, vomiting, and nausea or vomiting.
In presentation of data, the paragaphs of listed drugs with results is not an effective way to display results, perhaps tables would be easier to read.
The overall recommendation was against the use of routine PONV prophylaxis, unless the patient has a high risk. However in the recommendations there was no suggestions as to what would put a person at higher risk (are we to assume the usual risk factors? did the outcomes in the RCTs reflect this?). In order to assess the usefulness of the review, we used the example of answering the question: does ondansetron prevent post‐operative nausea or vomiting in a certain population (ex. gyne procedures).
The trials in the results forest plot showed a very high level of heterogeneity, thus results are questionable as to how this can be applicable to real life. Sub‐group analysis within the forest plot could allow for more specific structure of information and answer more specific questions in terms of either patient population of the RCT, dose of drug used, or procedure that was performed.No recommended dosage was given (or easily found) although the drug was shown to be efficacious.
Reply
The author agrees with this comment.
The author disagrees with this comment. The summary (particularly when tabulated as suggested in point 1.) can concisely communicate the results of the review. The review is answering a simple question: the outcomes assessed (PONV) are the same for all the drugs. An update might identify around 13 effective drugs, the effects of which can still be communicated simply. There were few side‐effects that achieved statistical significance, so these do not complicate the summary findings.The question being addressed by the review – that might be asked by patients or clinicians – is ‘what drugs can reduce the rate of PONV and by how much?’ and ‘what are their relative effects and side effects?’ This question is very difficult to answer if a patient or clinician has to hunt down multiple systematic reviews that have only looked at one or two drugs. Division of this review into multiple smaller reviews doesn’t allow for meta‐regression or indirect comparisons, it does not so easily permit the identification of fraudulent research or bias.
The systematic review reflects the outcomes that authors of RCTs have chosen to report. Some patients dislike vomiting but don’t mind being nauseated (so much), whilst other patients don’t mind vomiting as long as they don’t feel nauseated (much): not all patients who vomit are recorded as complaining of nausea. For these reasons separate analyses are helpful.
This will be considered in the update.
No, there was no recommendation. The summary factually stated how many patients might be expected to benefit and how many would not.
Due to lack of capacity for the Cochrane Library (in 2006) to accommodate subgroup analyses we did not display the various subgroup results, although we did report that type of surgery was not associated with interactions with antiemetic effects. Subgroup analyses did not reduce heterogeneity. There was also no interaction with age (adult vs child), sex (male vs female) and other factors as reported. We also reported on the effects of dosage.
Contributors
Summary: Andrew Wilson, Senior Student, University of British Columbia Medical School. I certify that I have no affiliations with or involvement in any organization or entity with a financial interest in the subject matter of my feedback.
Reply: John Carlisle, lead author.
What's new
| Date | Event | Description |
|---|---|---|
| 17 July 2017 | Amended | This review is being withdrawn by the Cochrane Review Group with the agreement of the authors, as, at the time of writing, 67 of the 737 studies included in the review have been retracted since the review was published, and there are also investigations ongoing for a number of other studies. Retracted studies and the analyses affected are listed in the Published notes |
History
Protocol first published: Issue 2, 2003 Review first published: Issue 3, 2006
| Date | Event | Description |
|---|---|---|
| 7 December 2016 | Amended | The future of this review is being considered. This is because it includes a large number of retracted studies. |
| 4 March 2014 | Amended | Feedback submitted |
| 20 June 2008 | Amended | Converted to new review format. |
Sources of support
Internal sources
Torbay Special Projects Fund, UK.
External sources
No sources of support supplied
Withdrawn from publication for reasons stated in the review