I am conducting a systematic review and meta analysis; as I am extracting data I realized there is a consort diagram that shows the number of patients from randomization till end of the study. So all the data is available if I want to extract based on intention to treat or based on per protocol ( patients who completed the intervention). I am wondering how should I proceed?
check these papers. one of them report PP and the other report ITT; however data is available for both to extract either one. what should I do?
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I would go with ITT. Using ITT is generally recommended over PP in Meta-Analyses.
It is worth mentioning that the method or definition of ITT can differ between the included trials, which will introduce some bias, that is out of your control. Still, ITT is more preferred. You can highlight this in your methods as well.
The two analyses answer two different questions: the effect of the intervention itself(PP) vs the effect of prescribing the intervention(ITT)- which should take into account that some interventions may be hard to use and cause a high dropout rate which is part of the effects of their actual real-life effect. Thus, it is generally preferred to use ITT in cases where there is a high drop-out rate to account for the probable effects of the intervention on nonadherence in real-life use of the intervention. Thus, when your question is whether the intervention is suitable to be used in practice, we always prefer ITT, especially when the dropout rate is high. If your question focuses on the effects of the intervention per se, PP analysis provides more accurate(lab-like) results.
Given the nature of your intervention and the assumed question of your SR, I would suggest that ITT would provide more useful results for decision-making.
For most systematic reviews, especially those focusing on the effectiveness of interventions, it is generally recommended to:
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