Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes
Authors: John E. Cornell, Cynthia D. Mulrow
Journal: Annals of Internal Medicine (2020)

Letters7 January 2020Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular OutcomesJohn E. Cornell, PhD and Cynthia D. Mulrow, MD, MScJohn E. Cornell, PhDAssociate Editor, Statistics (J.E.C.) and Cynthia D. Mulrow, MD, MScSenior Deputy Editor (C.D.M.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0716 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Khan and colleagues' umbrella review of the effects of nutritional supplements and dietary interventions on cardiovascular outcomes (1) elicited critiques based on the statistical methods they used to reestimate treatment effects. The authors used the Paule–Mandel method to estimate between-study variance (τ2), with the HKSJ adjustment when the number of studies was fewer than 10. Their choice is consistent with Hartung and Knapp's general recommendation to use the HKSJ adjustment with the Paule–Mandel estimate τ2 (2). It is also consistent with Veroniki and associates' general but tentative recommendations in a recent systematic review of methods to estimate ...References1. Khan SU, Khan MU, Riaz H, et al. Effects of nutritional supplements and dietary interventions on cardiovascular outcomes: an umbrella review and evidence map. Ann Intern Med. 2019;171:190-8. [PMID: 31284304]. doi:10.7326/M19-0341 LinkGoogle Scholar2. Knapp G, Hartung J. Improved tests for a random effects meta-regression with a single covariate. Stat Med. 2003;22:2693-710. [PMID: 12939780] CrossrefMedlineGoogle Scholar3. Veroniki AA, Jackson D, Bender R, et al. Methods to calculate uncertainty in the estimated overall effect size from a random-effects meta-analysis. Res Synth Methods. 2019;10:23-43. [PMID: 30129707] doi:10.1002/jrsm.1319 CrossrefMedlineGoogle Scholar4. Adler AJ, Taylor F, Martin N, et al. Reduced dietary salt for the prevention of cardiovascular disease. Cochrane Database Syst Rev. 2014:CD009217. [PMID: 25519688] doi:10.1002/14651858.CD009217.pub3 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Associate Editor, Statistics (J.E.C.)Senior Deputy Editor (C.D.M.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0716. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes Safi U. Khan , Muhammad U. Khan , Haris Riaz , Shahul Valavoor , Di Zhao , Lauren Vaughan , Victor Okunrintemi , Irbaz Bin Riaz , Muhammad Shahzeb Khan , Edo Kaluski , M. Hassan Murad , Michael J. Blaha , Eliseo Guallar , and Erin D. Michos Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes Jesper M. Kivelä Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes Martin Mayer Metrics Cited byImpact of the increasing concentrations of selected perfluoroalkyl acids on the observed concentrations of red blood cell folate among US adults aged ≥20 years 7 January 2020Volume 172, Issue 1Page: 75KeywordsBayesian methodDisclosureMortalityNutritionSaltsStatistical methodsSystematic reviews ePublished: 7 January 2020 Issue Published: 7 January 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...