Literature DB >> 23747228

Combining follow-up and change data is valid in meta-analyses of continuous outcomes: a meta-epidemiological study.

Bruno R da Costa1, Eveline Nüesch, Anne W Rutjes, Bradley C Johnston, Stephan Reichenbach, Sven Trelle, Gordon H Guyatt, Peter Jüni.   

Abstract

OBJECTIVE: To investigate whether it is valid to combine follow-up and change data when conducting meta-analyses of continuous outcomes. STUDY DESIGN AND
SETTING: Meta-epidemiological study of randomized controlled trials in patients with osteoarthritis of the knee/hip, which assessed patient-reported pain. We calculated standardized mean differences (SMDs) based on follow-up and change data, and pooled within-trial differences in SMDs. We also derived pooled SMDs indicating the largest treatment effect within a trial (optimistic selection of SMDs) and derived pooled SMDs from the estimate indicating the smallest treatment effect within a trial (pessimistic selection of SMDs).
RESULTS: A total of 21 meta-analyses with 189 trials with 292 randomized comparisons in 41,256 patients were included. On average, SMDs were 0.04 standard deviation units more beneficial when follow-up values were used (difference in SMDs: -0.04; 95% confidence interval: -0.13, 0.06; P=0.44). In 13 meta-analyses (62%), there was a relevant difference in clinical and/or significance level between optimistic and pessimistic pooled SMDs.
CONCLUSION: On average, there is no relevant difference between follow-up and change data SMDs, and combining these estimates in meta-analysis is generally valid. Decision on which type of data to use when both follow-up and change data are available should be prespecified in the meta-analysis protocol.
Copyright © 2013 Elsevier Inc. All rights reserved.

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Year:  2013        PMID: 23747228     DOI: 10.1016/j.jclinepi.2013.03.009

Source DB:  PubMed          Journal:  J Clin Epidemiol        ISSN: 0895-4356            Impact factor:   6.437


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