Totally agree that unadjusted are no better (and almost certainly worse). My impression from these data are that efforts to synthesize data from observational and randomized trials is even harder than the current literature base makes it out to be. Not sure about the fields you work in most commonly, but everyone in my end of neonatology seems to have their own pet characteristics to adjust for. Could this be addressed at all by working from an assumed baseline risk and then converting ORs to RRs or absolute risk?
Seeing you say this so matter-of-factly juxtaposed against the all to common narrative of univariate adjustments followed by adding predictors to show how odds ratios change in response to “adjustment” is a weird combination of funny and frustrating. I wonder if you would mind expanding on the last sentence, is this a marginal vs conditional type scenario?