OBJECTIVES: Individual patient data (IPD) meta-analyses have been proposed as a major improvement in meta-analytic methods to study subgroup effects. Subgroup effects of conventional and IPD meta-analyses using identical data have not been compared. Our objective is to compare such subgroup effects using the data of six trials (n = 1,643) on the effectiveness of antibiotics in children with acute otitis media (AOM). METHODS: Effects (relative risks, risk differences [RD], and their confidence intervals [CI]) of antibiotics in subgroups of children with AOM resulting from (i) conventional meta-analysis using summary statistics derived from published data (CMA), (ii) two-stage approach to IPD meta-analysis using summary statistics derived from IPD (IPDMA-2), and (iii) one-stage approach to IPD meta-analysis where IPD is pooled into a single data set (IPDMA-1) were compared. RESULTS: In the conventional meta-analysis, only two of the six studies were included, because only these reported on relevant subgroup effects. The conventional meta-analysis showed larger (age < 2 years) or smaller (age > or = 2 years) subgroup effects and wider CIs than both IPD meta-analyses (age < 2 years: RDCMA -21 percent, RDIPDMA-1 -16 percent, RDIPDMA-2 -15 percent; age > or =2 years: RDCMA -5 percent, RDIPDMA-1 -11 percent, RDIPDMA-2 -11 percent). The most important reason for these discrepant results is that the two studies included in the conventional meta-analysis reported outcomes that were different both from each other and from the IPD meta-analyses. CONCLUSIONS: This empirical example shows that conventional meta-analyses do not allow proper subgroup analyses, whereas IPD meta-analyses produce more accurate subgroup effects. We also found no differences between the one- and two-stage meta-analytic approaches.
OBJECTIVES: Individual patient data (IPD) meta-analyses have been proposed as a major improvement in meta-analytic methods to study subgroup effects. Subgroup effects of conventional and IPD meta-analyses using identical data have not been compared. Our objective is to compare such subgroup effects using the data of six trials (n = 1,643) on the effectiveness of antibiotics in children with acute otitis media (AOM). METHODS: Effects (relative risks, risk differences [RD], and their confidence intervals [CI]) of antibiotics in subgroups of children with AOM resulting from (i) conventional meta-analysis using summary statistics derived from published data (CMA), (ii) two-stage approach to IPD meta-analysis using summary statistics derived from IPD (IPDMA-2), and (iii) one-stage approach to IPD meta-analysis where IPD is pooled into a single data set (IPDMA-1) were compared. RESULTS: In the conventional meta-analysis, only two of the six studies were included, because only these reported on relevant subgroup effects. The conventional meta-analysis showed larger (age < 2 years) or smaller (age > or = 2 years) subgroup effects and wider CIs than both IPD meta-analyses (age < 2 years: RDCMA -21 percent, RDIPDMA-1 -16 percent, RDIPDMA-2 -15 percent; age > or =2 years: RDCMA -5 percent, RDIPDMA-1 -11 percent, RDIPDMA-2 -11 percent). The most important reason for these discrepant results is that the two studies included in the conventional meta-analysis reported outcomes that were different both from each other and from the IPD meta-analyses. CONCLUSIONS: This empirical example shows that conventional meta-analyses do not allow proper subgroup analyses, whereas IPD meta-analyses produce more accurate subgroup effects. We also found no differences between the one- and two-stage meta-analytic approaches.
Authors: Stefan Schandelmaier; Matthias Briel; Ravi Varadhan; Christopher H Schmid; Niveditha Devasenapathy; Rodney A Hayward; Joel Gagnier; Michael Borenstein; Geert J M G van der Heijden; Issa J Dahabreh; Xin Sun; Willi Sauerbrei; Michael Walsh; John P A Ioannidis; Lehana Thabane; Gordon H Guyatt Journal: CMAJ Date: 2020-08-10 Impact factor: 8.262
Authors: Annelies Wilder-Smith; Yinghui Wei; Thalia Velho Barreto de Araújo; Maria VanKerkhove; Celina Maria Turchi Martelli; Marília Dalva Turchi; Mauro Teixeira; Adriana Tami; João Souza; Patricia Sousa; Antoni Soriano-Arandes; Carmen Soria-Segarra; Nuria Sanchez Clemente; Kerstin Daniela Rosenberger; Ludovic Reveiz; Arnaldo Prata-Barbosa; Léo Pomar; Luiza Emylce Pelá Rosado; Freddy Perez; Saulo D Passos; Mauricio Nogueira; Trevor P Noel; Antônio Moura da Silva; Maria Elisabeth Moreira; Ivonne Morales; Maria Consuelo Miranda Montoya; Demócrito de Barros Miranda-Filho; Lauren Maxwell; Calum N L Macpherson; Nicola Low; Zhiyi Lan; Angelle Desiree LaBeaud; Marion Koopmans; Caron Kim; Esaú João; Thomas Jaenisch; Cristina Barroso Hofer; Paul Gustafson; Patrick Gérardin; Jucelia S Ganz; Ana Carolina Fialho Dias; Vanessa Elias; Geraldo Duarte; Thomas Paul Alfons Debray; María Luisa Cafferata; Pierre Buekens; Nathalie Broutet; Elizabeth B Brickley; Patrícia Brasil; Fátima Brant; Sarah Bethencourt; Andrea Benedetti; Vivian Lida Avelino-Silva; Ricardo Arraes de Alencar Ximenes; Antonio Alves da Cunha; Jackeline Alger Journal: BMJ Open Date: 2019-06-18 Impact factor: 2.692
Authors: Catrin Tudur Smith; Maura Marcucci; Sarah J Nolan; Alfonso Iorio; Maria Sudell; Richard Riley; Maroeska M Rovers; Paula R Williamson Journal: Cochrane Database Syst Rev Date: 2016-09-06
Authors: Dipak Kotecha; Luis Manzano; Henry Krum; Giuseppe Rosano; Jane Holmes; Douglas G Altman; Peter D Collins; Milton Packer; John Wikstrand; Andrew J S Coats; John G F Cleland; Paulus Kirchhof; Thomas G von Lueder; Alan S Rigby; Bert Andersson; Gregory Y H Lip; Dirk J van Veldhuisen; Marcelo C Shibata; Hans Wedel; Michael Böhm; Marcus D Flather Journal: BMJ Date: 2016-04-20
Authors: Thomas P A Debray; Karel G M Moons; Gert van Valkenhoef; Orestis Efthimiou; Noemi Hummel; Rolf H H Groenwold; Johannes B Reitsma Journal: Res Synth Methods Date: 2015-08-19 Impact factor: 5.273