Meta-analysis for 2 x 2 tables: a Bayesian approach.

This paper develops and implements a fully Bayesian approach to meta-analysis, in which uncertainty about effects in distinct but comparable studies is represented by an exchangeable prior distribution. Specifically, hierarchical normal models are used, along with a parametrization that allows a unified approach to deal easily with both clinical trial and case-control study data. Monte Carlo methods are used to obtain posterior distributions for parameters of interest, integrating out the unknown parameters of the exchangeable prior or 'random effects' distribution. The approach is illustrated with two examples, the first involving a data set on the effect of beta-blockers after myocardial infarction, and the second based on a classic data set comprising 14 case-control studies on the effects of smoking on lung cancer. In both examples, rather different conclusions from those previously published are obtained. In particular, it is claimed that widely used methods for meta-analysis, which involve complete pooling of 'O-E' values, lead to understatement of uncertainty in the estimation of overall or typical effect size.