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Cranberries and Urinary Tract Infections: How Can the Same Evidence Lead to Conflicting Advice?

Abstract

Cranberry has been used traditionally to prevent urinary tract infections (UTIs), primarily among generally healthy women prone to recurrent UTIs. Results from a number of published clinical studies have supported this benefit; however, meta-analyses on cranberry and UTI prevention have reported conflicting conclusions. This article explores the methodological differences that contributed to these disparate findings. Despite similar research questions, the meta-analyses varied in the studies that were included, as well as the data that were extracted. In the 2 most comprehensive systematic reviews, heterogeneity was handled differently, leading to an I(2) of 65% in one and 43% in the other. Most notably, the populations influencing the conclusions varied. In one analysis, populations with pathological/physiological conditions contributed 75.6% of the total weight to the summary risk estimate (RR: 0.86; 95% CI: 0.71, 1.04); another weighted the evidence relatively equally across UTI populations (RR: 0.62; 95% CI: 0.49, 0.80); and a third included only women with recurrent UTIs (RR: 0.53; 95% CI: 0.33, 0.83). Because women with recurrent UTIs are the group to whom most recommendations regarding cranberry consumption is directed, inclusion of other groups in the efficacy assessment could influence clinical practice quality. Therefore, conclusions on cranberry and UTIs should consider differences in results across various populations studied when interpreting results from meta-analyses.

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  • Authors+Show Affiliations

    ,

    Biofortis Innovation Services, Addison, IL; and deann.liska@mxns.com.

    ,

    Biofortis Innovation Services, Addison, IL; and.

    Midwest Center for Metabolic & Cardiovascular Research, Chicago, IL.

    Source

    MeSH

    Biomedical Research
    Female
    Fruit
    Humans
    Patient Selection
    Phytotherapy
    Plant Extracts
    Urinary Tract Infections
    Vaccinium macrocarpon

    Pub Type(s)

    Journal Article
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    27184277

    Citation

    Liska, DeAnn J., et al. "Cranberries and Urinary Tract Infections: How Can the Same Evidence Lead to Conflicting Advice?" Advances in Nutrition (Bethesda, Md.), vol. 7, no. 3, 2016, pp. 498-506.
    Liska DJ, Kern HJ, Maki KC. Cranberries and Urinary Tract Infections: How Can the Same Evidence Lead to Conflicting Advice? Adv Nutr. 2016;7(3):498-506.
    Liska, D. J., Kern, H. J., & Maki, K. C. (2016). Cranberries and Urinary Tract Infections: How Can the Same Evidence Lead to Conflicting Advice? Advances in Nutrition (Bethesda, Md.), 7(3), pp. 498-506. doi:10.3945/an.115.011197.
    Liska DJ, Kern HJ, Maki KC. Cranberries and Urinary Tract Infections: How Can the Same Evidence Lead to Conflicting Advice. Adv Nutr. 2016;7(3):498-506. PubMed PMID: 27184277.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cranberries and Urinary Tract Infections: How Can the Same Evidence Lead to Conflicting Advice? AU - Liska,DeAnn J, AU - Kern,Hua J, AU - Maki,Kevin C, Y1 - 2016/05/16/ PY - 2016/5/18/entrez PY - 2016/5/18/pubmed PY - 2017/11/3/medline KW - cranberry KW - meta-analysis KW - systematic review KW - urinary tract infections KW - women SP - 498 EP - 506 JF - Advances in nutrition (Bethesda, Md.) JO - Adv Nutr VL - 7 IS - 3 N2 - Cranberry has been used traditionally to prevent urinary tract infections (UTIs), primarily among generally healthy women prone to recurrent UTIs. Results from a number of published clinical studies have supported this benefit; however, meta-analyses on cranberry and UTI prevention have reported conflicting conclusions. This article explores the methodological differences that contributed to these disparate findings. Despite similar research questions, the meta-analyses varied in the studies that were included, as well as the data that were extracted. In the 2 most comprehensive systematic reviews, heterogeneity was handled differently, leading to an I(2) of 65% in one and 43% in the other. Most notably, the populations influencing the conclusions varied. In one analysis, populations with pathological/physiological conditions contributed 75.6% of the total weight to the summary risk estimate (RR: 0.86; 95% CI: 0.71, 1.04); another weighted the evidence relatively equally across UTI populations (RR: 0.62; 95% CI: 0.49, 0.80); and a third included only women with recurrent UTIs (RR: 0.53; 95% CI: 0.33, 0.83). Because women with recurrent UTIs are the group to whom most recommendations regarding cranberry consumption is directed, inclusion of other groups in the efficacy assessment could influence clinical practice quality. Therefore, conclusions on cranberry and UTIs should consider differences in results across various populations studied when interpreting results from meta-analyses. SN - 2156-5376 UR - https://www.unboundmedicine.com/medline/citation/27184277/full_citation L2 - https://academic.oup.com/advances/article-lookup/doi/10.3945/an.115.011197 DB - PRIME DP - Unbound Medicine ER -