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Gallois et al. (2022)
13
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Objective, main outcomes, patient inclusion criteria, patient characteristics, and interventions were clearly described Main findings were clearly described including the 95% confidence interval and actual p-values where reported As this is a retrospective review, it is possible that patients were representative of the population of interest and the treatment received was representative of typical treatment All patients were recruited from the same locations Statistical tests appear to have been appropriate, including use of survival analysis for survival outcomes Compliance with the intervention was likely reliable Main outcome measures were likely accurate and reliable Reported conflicts of interest and funding
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List of confounders not provided Unclear if all important adverse events were reported Unclear if patients who participated in this study were representative of the entire population Comparisons were within-group (before-after) or no comparator; without between-group comparisons (i.e., without a separate control group that received a different treatment, placebo, or no treatment), the results are susceptible to several types of bias, which may impact internal and external validity; overall, all findings should be interpreted with caution, as uncontrolled factors may have influenced the findings Unlikely that participants or research staff were blinded to treatment; however, the outcome was objective, so it is unlikely this caused bias Unclear if subgroup analyses were pre-planned Patients varied in the number of cycles they received; it is unclear if this could have impacted outcomes, or if this was considered in the analysis Patients were not randomized to intervention Unclear if a sample size was calculated
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Batra et al. (2021)
14
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Objective, main outcomes, patient inclusion criteria, patient characteristics, and interventions were clearly described Main findings were clearly described including the 95% confidence interval and actual p-values where reported As this is a retrospective review, it is possible that patients were representative of the population of interest and the treatment received was representative of typical treatment All patients were recruited from the same locations Discussed potential causes of heterogeneity in their results Statistical tests appear to have been appropriate Compliance with the intervention was likely reliable Main outcome measures were likely accurate and reliable Reported no conflicts of interest
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List of confounders not provided Unclear if all important adverse events were reported Unclear if patients who participated in this study were representative of the entire population Unlikely that participants or research staff were blinded to treatment; however, the outcome was objective, so it is unlikely this caused bias Comparisons were within-group (before-after) or no comparator; without between-group comparisons (i.e., without a separate control group that received a different treatment, placebo, or no treatment), the results are susceptible to several types of bias, which may impact internal and external validity; overall, all findings should be interpreted with caution, as uncontrolled factors may have influenced the findings Unclear if subgroup analyses were pre-planned Patients varied in the number of cycles they received; it is unclear if this could have impacted outcomes, or if this was considered in the analysis Patients were not randomized to intervention Unclear if a sample size was calculated, though this was a population-based study Did not report funding
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Khan et al. (2019)
15
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Objective, main outcomes, patient inclusion criteria, patient characteristics, and interventions were clearly described Main results were clearly described including the 95% confidence interval and actual p-values where reported As this is a retrospective review, it is possible that patients were representative of the population of interest and the treatment received was representative of typical treatment All patients were recruited from the same locations Statistical tests appear to have been appropriate, including use of survival analysis for survival outcomes Compliance with the intervention was likely reliable Main outcome measures were likely accurate and reliable Reported conflicts of interest
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Subgroup comparisons did not report the 95% confidence interval List of confounders not provided Unclear if all important adverse events were reported Unclear if patients who participated in this study were representative of the entire population Unlikely that participants or research staff were blinded to treatment; however, the outcome was objective, so it is unlikely this caused bias Comparisons were within-group (before-after); without between-group comparisons (i.e., without a separate control group that received a different treatment, placebo, or no treatment), the results are susceptible to several types of bias, which may impact internal and external validity; overall, all findings should be interpreted with caution, as uncontrolled factors may have influenced the findings Unclear if subgroup analyses were pre-planned Patients varied in the number of cycles they received; it is unclear if this could have impacted outcomes, or if this was considered in the analysis Patients were not randomized to intervention Unclear if a sample size was calculated Unclear reporting of funding
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Ransom et al. (2014)
16
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Objective, main outcome, patient inclusion criteria, and interventions were clearly described Main findings were clearly described including the 95% confidence interval and actual P value As this is a retrospective review, it is possible that patients included in this study were representative of the population of interest and that the treatment received was representative of typical treatment All patients appear to have been recruited from the same locations (participating centres) No retrospective unplanned subgroup analyses were reported Compliance with the intervention was likely reliable Main outcome measure was likely accurate and reliable Reported source of funding and no conflicts of interest
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Patient characteristics not well-described other than type of cancer and risk of cardiac event; missing age, sex, and so forth List of confounders not provided Unclear if all important adverse events were reported Unclear if patients who participated in this study were representative of the entire population Unlikely that participants or research staff were blinded to treatment; however, the outcome was objective, so it is unlikely this caused bias Comparisons were within-group (before-after); without between-group comparisons (i.e., without a separate control group that received a different treatment, placebo, or no treatment), the results are susceptible to several types of bias, which may impact internal and external validity; overall, all findings should be interpreted with caution, as uncontrolled factors may have influenced the findings Follow-up was up to 30 days after the last dose of raltitrexed, but patients varied in the number of cycles they received; it is unclear if this could have impacted outcomes, or if this was considered in the analysis Statistical test used was not described Analysis did not appear to adjust for confounding Patients were not randomized to intervention Unclear if a sample size was calculated
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Kelly et al. (2013)
12
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Objective, main outcomes, patient inclusion criteria, patient characteristics, and interventions were clearly described As this is a retrospective review, it is possible that patients were representative of the population of interest and the treatment received was representative of typical treatment All patients were recruited from the same locations Compliance with the intervention was likely reliable Main outcome measures were likely accurate and reliable Reported conflicts of interest
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Main findings were not reported in detail, and did not present 95% confidence intervals or p-values as no statistical analyses were conducted List of confounders not provided; unclear if these results may be biased due to confounding Unclear if all important adverse events were reported Unclear if patients who participated in this study were representative of the entire population Unlikely that participants or research staff were blinded to treatment; however, the outcome was objective, so it is unlikely this caused bias Comparisons were within-group (before-after); without between-group comparisons (i.e., without a separate control group that received a different treatment, placebo, or no treatment), the results are susceptible to several types of bias, which may impact internal and external validity; overall, all findings should be interpreted with caution, as uncontrolled factors may have influenced the findings Number of cycles and follow-up length were not reported Patients were not randomized to intervention Unclear if a sample size was calculated Unclear reporting of funding
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