A latent normal distribution model for analysing ordinal responses with applications in meta-analysis.

We consider the comparison of two treatments (or a treatment and a control/placebo) with responses that are classified into ordinal categories. By operating on the assumption that the responses are manifestations of some underlying continuous variables and that the definitions of the categories for the treatment group and the placebo group are the same in the same clinical test centre, we develop a model to examine the possible treatment effects. These treatment effects can be identified as location effect or dispersion effect. The method can be generalized to analyse clinical test results coming from different centres, where each centre may have its own standard in classifying responses. The method is technically undemanding and can be implemented in a very simple and straightforward way by using easily accessible software that can be downloaded at no cost. Real data sets are analysed for illustration. Copyright 2004 John Wiley & Sons, Ltd.