Evidence Table 31Quality assessment of observational studies in youths

Non-biased selection?High overall loss to follow-up or differential loss to follow up?Outcomes pre-specified and defined?Ascertainment techniques adequately described?Non-biased and adequate ascertainment methods?Statistical analysis of potential confounders?Adequate duration of follow-up?Overall quality rating
Correll 2009 (SATIETY)Unclear; 173/505 (34%) who refused to participate or were ineligible had less autism-spectrum disorders, substance abuse comorbidity, and mixed ethnicity18% excluded from analysis overall due to lack of post-baseline assessment 20% excluded from analysis for quetiapine and risperidone, vs 13% for aripiprazole and olanzapineYesYesYesSome, categorical outcomes adjusted for differences at baseline, others analyzed by stratification and other methods.NoFair
Fleischhaker 2006Unclear; distribution across comparison groups of different diagnoses, prior experience with antipsychotic agents and use of co-medications NR; numerically lower proportion of males in olanzapine group compared to clozapine and risperidone (56% vs 69% vs 68%)Attrition NR; all 51 participants included in analysisYesYesUnclear about reliability/validity of adapted version of Dosage Record Treatment Emergent Symptom Scale (DOTES) (e.g., computerized, German language, included additional information from chart review)Stratified by drug-naiveté and comedication use for weight gainNo; mean=7.4 weeksPoor
Fleischhaker 2008Yes46% (28/61) excluded due to early discontinuation (34%), low number of weight and height measurements (8%) and anorexia nervosa (3%); attrition per treatment group NRYesYesYesYes for change in BMI standard deviation scores (SDS), unclear for others. Reported that "since the groups differed significantly in age [at baseline], several analyses were conducted to test the influence of age that is confounded with medication group. " No linear or monotone relationships found for BMI-SDS. Results for others NR.YesFair
Fraguas 2008YesYes/Yes
Overall=28%, risperidone=42%, olanzapine=20%, quetiapine=17%
YesYesYesYes for age, BMI z score, psychosis, duration of prior total lifetime antipsychotic usageYesFair

From: Evidence Tables

Cover of Drug Class Review: Atypical Antipsychotic Drugs
Drug Class Review: Atypical Antipsychotic Drugs: Final Update 3 Report [Internet].
McDonagh M, Peterson K, Carson S, et al.
Portland (OR): Oregon Health & Science University; 2010 Jul.
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