{"doi":"10.1136/bjsports-2015-f5577rep","title":"Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study","abstract":"<h4>Objective</h4>To determine the comparative effectiveness of exercise versus drug interventions on mortality outcomes.<h4>Design</h4>Metaepidemiological study.<h4>Eligibility criteria</h4>Meta-analyses of randomised controlled trials with mortality outcomes comparing the effectiveness of exercise and drug interventions with each other or with control (placebo or usual care).<h4>Data sources</h4>Medline and Cochrane Database of Systematic Reviews, May 2013.<h4>Main outcome measure</h4>Mortality.<h4>Data synthesis</h4>We combined study level death outcomes from exercise and drug trials using random effects network meta-analysis.<h4>Results</h4>We included 16 (four exercise and 12 drug) meta-analyses. Incorporating an additional three recent exercise trials, our review collectively included 305 randomised controlled trials with 339,274 participants. Across all four conditions with evidence on the effectiveness of exercise on mortality outcomes (secondary prevention of coronary heart disease, rehabilitation of stroke, treatment of heart failure, prevention of diabetes), 14,716 participants were randomised to physical activity interventions in 57 trials. No statistically detectable differences were evident between exercise and drug interventions in the secondary prevention of coronary heart disease and prediabetes. Physical activity interventions were more effective than drug treatment among patients with stroke (odds ratios, exercise vanticoagulants 0.09, 95% credible intervals 0.01 to 0.70 and exercise v antiplatelets 0.10, 0.01 to 0.62). Diuretics were more effective than exercise in heart failure (exercise v diuretics 4.11,1.17 to 24.76). Inconsistency between direct and indirect comparisons was not significant.<h4>Conclusions</h4>Although limited in quantity, existing randomised trial evidence on exercise interventions suggests that exercise and many drug interventions are often potentially similar in terms of their mortality benefits in the secondary prevention of coronary heart disease, rehabilitation after stroke, treatment of heart failure, and prevention of diabetes.","journal":"British Journal of Sports Medicine","year":2015,"id":3567,"datarank":5.944468302555367,"base_score":5.327876168789581,"endowment":5.327876168789581,"self_citation_contribution":0.7991814253184373,"citation_network_contribution":5.14528687723693,"self_endowment_contribution":0.7991814253184373,"citer_contribution":5.14528687723693,"corpus_percentile":96.65042159820531,"corpus_rank":434,"citation_count":205,"citer_count":100,"citers_with_citation_signal":100,"citers_with_endowment":100,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5278,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2015-10-16","fair_score":24.7917,"fair_percentile":5.077262693156733,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":148,"name":"John P. A. Ioannidis","orcid":"0000-0003-3118-6859","position":1,"is_corresponding":false},{"id":15026,"name":"Huseyin Naci","orcid":"0000-0002-7192-5751","position":0,"is_corresponding":true}],"reference_count":68,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-03-01T18:20:47.508186Z","pmid":"26476429","pmcid":"PMC4680125","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":40.0,"fair_a":42.5,"fair_i":0.0,"fair_r":16.6667,"fair_zscore":-1.6374,"fair_rationale":{"fair_score":24.79,"has_llm":true,"dimensions":{"F":{"name":"Findable","score":40.0,"criteria":[{"key":"f_has_doi","label":"Has a persistent DOI","kind":"deterministic","weight":1.0,"fraction":1.0,"signal":"DOI present","rationale":null},{"key":"f_repository_presence","label":"Indexed in repositories / literature DBs","kind":"deterministic","weight":1.0,"fraction":1.0,"signal":"datacite=0, pmcid=True, pmid=True","rationale":null},{"key":"f_persistent_ids","label":"Resolvable scholarly identifiers (OpenAlex)","kind":"deterministic","weight":0.5,"fraction":0.0,"signal":"no OpenAlex id","rationale":null},{"key":"f_metadata_richness","label":"Rich, machine-readable metadata","kind":"llm","weight":1.0,"fraction":0.0,"signal":null,"rationale":"The paper provides no machine-readable metadata such as structured data file, formal ontology, or persistent identifier for its data."}]},"A":{"name":"Accessible","score":42.5,"criteria":[{"key":"a_open_access","label":"Open Access / files deposited","kind":"deterministic","weight":1.5,"fraction":1.0,"signal":"Open Access","rationale":null},{"key":"a_retrievable","label":"Free full text retrievable","kind":"deterministic","weight":1.0,"fraction":0.0,"signal":"0 OA location(s)","rationale":null},{"key":"a_access_protocol","label":"Clear data/code access protocol","kind":"llm","weight":1.0,"fraction":0.25,"signal":null,"rationale":"The paper states raw data is available on request from the corresponding author, but provides no repository, direct link, or automated access mechanism."}]},"I":{"name":"Interoperable","score":0.0,"criteria":[{"key":"i_linked_data","label":"Linked datasets / DataCite relations","kind":"deterministic","weight":1.0,"fraction":0.0,"signal":"linked_datasets=0, datacite=0","rationale":null},{"key":"i_standard_ids","label":"References data via standard accessions","kind":"deterministic","weight":1.0,"fraction":0.0,"signal":"accessions=0, trials=0","rationale":null},{"key":"i_standards","label":"Standard formats, vocabularies & identifiers","kind":"llm","weight":1.0,"fraction":0.0,"signal":null,"rationale":"The paper does not mention use of standard data formats, controlled vocabularies, or unique identifiers for its data or code."}]},"R":{"name":"Reusable","score":16.67,"criteria":[{"key":"r_license","label":"Clear, open reuse license","kind":"deterministic","weight":1.5,"fraction":0.0,"signal":"no license","rationale":null},{"key":"r_downloads","label":"Demonstrated reuse (downloads)","kind":"deterministic","weight":0.5,"fraction":0.0,"signal":"downloads=0","rationale":null},{"key":"r_version","label":"Versioned / maintained","kind":"deterministic","weight":0.5,"fraction":0.0,"signal":"no version chain","rationale":null},{"key":"r_dataset","label":"Classified as a data resource","kind":"deterministic","weight":0.5,"fraction":1.0,"signal":"is_dataset","rationale":null},{"key":"r_reusability","label":"Data-availability statement, license & reproducibility","kind":"llm","weight":2.0,"fraction":0.167,"signal":null,"rationale":"The paper includes a CC BY-NC 4.0 license and a data-availability statement, but provides no deposited data/code, documentation, or explicit reproducibility instructions."}]}},"suggestions":["Deposit the raw data (e.g., extracted trial-level death counts) in a public repository such as Figshare or Zenodo with a DOI and machine-readable metadata.","Include a structured data availability statement with a direct link to the deposited dataset and a clear reuse license.","Provide the analysis code (e.g., WinBUGS models) in the repository along with a README file explaining inputs, outputs, and dependencies.","Use standard identifiers (e.g., RRID, ORCID) for key resources and authors, and consider using controlled vocabularies (e.g., MeSH) for interventions and conditions.","Add a formal reproducibility checklist or section describing how to reproduce all tables and figures from the deposited data and code."],"model":"deepseek/deepseek-v4-flash","agent_version":"fair_agent_v2","fulltext_source":"epmc_xml"},"fair_model":"deepseek/deepseek-v4-flash","fair_agent_version":"fair_agent_v2","fair_fulltext_source":"epmc_xml","fair_has_llm":true,"fair_computed_at":"2026-06-18T00:37:04.980628Z","clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}