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Appleton KM, Sallis HM, Perry R, et al. w-3 fatty acids for major depressive disorder in adults: An abridged Cochrane review. BMJ Open 2016;6:e010172 doi:10.1136/bmjopen-2015-010172

It has recently transpired that the MADRS scores used in the analyses for our Cochrane review for the trial by Bot et al (2010) were reversed between intervention and placebo groups. These data resulted from correspondence with the authors of this trial and they have recently confirmed an error. Reversal of the data for these groups changes our results minimally, does not change our interpretation of our results and does not change our conclusions.

Changes to the results of all affected analyses (n-3PUFAs vs placebo: depressive symptomology – continuous data) are given in our Cochrane review (Appleton KM, Sallis HM, Perry R, et al. Omega-3 fatty acids for depression in adults. Cochrane Database Syst Rev 2015;11:CD004692). Changes to the analyses included in this abridged publication are as follows:

Main analyses: published result – SMD=-0.32 (95% CI −0.52 to −0.12), I2=58%; revised result –SMD=−0.30 (95% CI −0.50 to −0.10), I2=59%. This result represents a difference between groups in scores on the HDRS (17-item) of approximately 2.1 points (95% CI 0.7 to 3.5).

Subgroup analyses based on presence/absence of comorbidities: published result – χ2=7.23, df=2, p=0.03, I2=72%; revised result – χ2=6.32, df=2, p=0.04, I2=68%. Subgroup analyses based on presence/absence of adjunctive therapies: published result – χ2=1.01, df=2, p=0.60, I2=0%; revised result – χ2=1.46, df=2, p=0.48, I2=0%.

Sensitivity analyses using fixed effects models: published result – SMD=−0.20 (95% CI −0.31 to −0.09); revised result – SMD=−0.19 (95% CI −0.30 to −0.08). Sensitivity analyses based on selection bias: published result – SMD=−0.21 (95% CI −0.45 to 0.03); revised result – SMD=−0.18 (95% CI −0.42 to 0.06). Sensitivity analyses based on performance bias: published result – SMD=−0.14 (95% CI −0.55 to 0.26); revised result – SMD=−0.07 (95% CI −0.48 to 0.35).

Additional sensitivity analyses based on use of a treatment that was solely EPA: published result – SMD=-0.45 (95% CI −0.74 to −0.15); revised result – SMD=−0.37 (95% CI −0.66 to −0.08).

Figure 3 and Figure 5 also change accordingly. Please see corrected figures below.

Figure 3

Forest plot for the outcome depressive symptomology (continuous) for the comparison of n-3PUFAs with placebo.

Figure 5

Funnel plot for the outcome depressive symptomology (continuous) for the comparison of n-3 polyunsaturated fatty acids with placebo.

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