PMID- 34599661
OWN - NLM
STAT- MEDLINE
DCOM- 20220225
LR  - 20231116
IS  - 1432-1041 (Electronic)
IS  - 0031-6970 (Print)
IS  - 0031-6970 (Linking)
VI  - 78
IP  - 1
DP  - 2022 Jan
TI  - Sports nutrition supplements and adverse events - a meta-epidemiological study of 
      case reports specifically addressing causality assessment.
PG  - 1-9
LID - 10.1007/s00228-021-03223-9 [doi]
AB  - PURPOSE: This meta-epidemiological study aimed to systematically review case 
      reports regarding sports nutrition supplements and adverse events (AEs), 
      specifically addressing the issue of causality assessments. METHODS: Through a 
      systematic literature search we identified all published case reports of AEs 
      associated with sports nutrition supplements between 1 January 2008 and 1 March 
      2019. Data regarding AEs, suspected supplements, relevant causality assessment 
      factors and the reporting of clinical reasoning and/or systematic causality 
      assessment methods were extracted. RESULTS: In all, 72 publications were 
      included, reporting 134 supplements and 37 different AEs in 97 patients (85% 
      males; median age: 30 years [range: 14-60]). Information regarding previous 
      health and regular prescription drugs was not presented in 30% (29/97) and 46% 
      (45/97) of cases, respectively. In 23% (22/97) of the cases, no alternative cause 
      was mentioned. Clinical reasoning was identified in 63% (61/97), and in 13% 
      (8/61) of these, a systematic causality assessment method was applied. In cases 
      with clinical reasoning, a theoretic rationale (92% vs 78%, P = 0.05), a 
      description of previous cases (90% vs 72%, P = 0.021) and body fluid analysis 
      (18% vs 3%, P = 0.027) were reported to a greater extent. Among cases with 
      clinical reasoning, the application of a systematic causality assessment method 
      captured additional important aspects: use of medication (100% vs 55%, 
      P = 0.015), alcohol use (88% vs 43%, P = 0.020) and illicit drug use (88% vs 40%, 
      P = 0.011). CONCLUSIONS: In published case reports where sports nutrition 
      supplements were suspected to have caused AEs, essential factors for causality 
      assessment were left out in a non-negligible proportion. Clinical reasoning was 
      identified in most cases whereas a systematic causality assessment method was 
      applied in a minority. Factors of importance for causality assessment were 
      reported to a greater extent in cases including clinical reasoning, and the 
      application of a systematic causality assessment method captured additional 
      aspects of importance.
CI  - (c) 2021. The Author(s).
FAU - Zeijlon, Rickard
AU  - Zeijlon R
AD  - Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, 
      Sweden. rickard.zeijlon@gu.se.
AD  - Department of Medicine, Sahlgrenska Academy, University of Gothenburg, 
      Gothenburg, Sweden. rickard.zeijlon@gu.se.
FAU - Hantelius, Victor
AU  - Hantelius V
AD  - Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, 
      Sweden.
FAU - Wallerstedt, Susanna M
AU  - Wallerstedt SM
AD  - Department of Pharmacology, Sahlgrenska Academy, University of Gothenburg, 
      Gothenburg, Sweden.
AD  - HTA-Centrum, Sahlgrenska University Hospital, Gothenburg, Sweden.
FAU - Holmqvist, Lina
AU  - Holmqvist L
AD  - Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, 
      Sweden.
AD  - Department of Medicine, Sahlgrenska Academy, University of Gothenburg, 
      Gothenburg, Sweden.
AD  - Gothenburg Emergency Medicine Research Group, GEMREG, Sahlgrenska University 
      Hospital, Gothenburg, Sweden.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
DEP - 20211002
PL  - Germany
TA  - Eur J Clin Pharmacol
JT  - European journal of clinical pharmacology
JID - 1256165
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Causality
MH  - Dietary Supplements/*adverse effects
MH  - Epidemiologic Studies
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Sports Nutritional Sciences
MH  - Young Adult
PMC - PMC8724217
OTO - NOTNLM
OT  - Adverse event
OT  - Causality assessment
OT  - Clinical reasoning
OT  - Dietary supplement
COIS- Rickard Zeijlon, Victor Hantelius, Susanna M. Wallerstedt and Lina Holmqvist 
      declare that they have no conflicts of interest.
EDAT- 2021/10/03 06:00
MHDA- 2022/02/26 06:00
PMCR- 2021/10/02
CRDT- 2021/10/02 12:03
PHST- 2021/03/05 00:00 [received]
PHST- 2021/07/30 00:00 [accepted]
PHST- 2021/10/03 06:00 [pubmed]
PHST- 2022/02/26 06:00 [medline]
PHST- 2021/10/02 12:03 [entrez]
PHST- 2021/10/02 00:00 [pmc-release]
AID - 10.1007/s00228-021-03223-9 [pii]
AID - 3223 [pii]
AID - 10.1007/s00228-021-03223-9 [doi]
PST - ppublish
SO  - Eur J Clin Pharmacol. 2022 Jan;78(1):1-9. doi: 10.1007/s00228-021-03223-9. Epub 
      2021 Oct 2.