Meta-Analysis of Odds Ratios: Current Good Practices.
Background: Many systematic reviews of randomized clinical trials lead to meta-analyses of odds ratios (ORs). The customary methods of estimating an overall OR involve weighted averages of the individual trials' estimates of the logarithm of the OR. That approach, however, has several shortcomings,...
| Publicado en: | Medical Care Vol. 55; no. 4; pp. 328 - 336 |
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| Autores principales: | , |
| Formato: | research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Apr2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=121906763&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 121906763 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00257079 21B jtl: Medical Care issn: 00257079 maglogo: N pubinfo: dt: Apr2017 vid: 55 iid: 4 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 121906763 121906763 NLM28169977 121906763 10.1097/MLR.0000000000000696 NLM28169977 121906763 ppf: 328 ppct: 8 formats: tig: atl: Meta-Analysis of Odds Ratios: Current Good Practices. aug: au: Chang, Bei-Hung Hoaglin, David C affil: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA sug: subj: Software Odds Ratio Endoscopy Liver Cirrhosis Therapy Study Design Sclerotherapy Esophageal and Gastric Varices Therapy Human Meta Analysis ab: Background: Many systematic reviews of randomized clinical trials lead to meta-analyses of odds ratios (ORs). The customary methods of estimating an overall OR involve weighted averages of the individual trials' estimates of the logarithm of the OR. That approach, however, has several shortcomings, arising from assumptions and approximations, that render the results unreliable. Although the problems have been documented in the literature for many years, the conventional methods persist in software and applications. A well-developed alternative approach avoids the approximations by working directly with the numbers of subjects and events in the arms of the individual trials.Objective: We aim to raise awareness of methods that avoid the conventional approximations, can be applied with widely available software, and produce more-reliable results.Methods: We summarize the fixed-effect and random-effects approaches to meta-analysis; describe conventional, approximate methods and alternative methods; apply the methods in a meta-analysis of 19 randomized trials of endoscopic sclerotherapy in patients with cirrhosis and esophagogastric varices; and compare the results. We demonstrate the use of SAS, Stata, and R software for the analysis.Results: In the example, point estimates and confidence intervals for the overall log-odds-ratio differ between the conventional and alternative methods, in ways that can affect inferences. Programming is straightforward in the 3 software packages; an appendix, Suppemental Digital Content 1 (http://links.lww.com/MLR/B335) gives the details.Conclusions: The modest additional programming required should not be an obstacle to adoption of the alternative methods. Because their results are unreliable, use of the conventional methods for meta-analysis of ORs should be discontinued. pubtype: Academic Journal doctype: meta analysis research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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