- 作者：Bruno R. da Costa ; Eveline N¨¹esch ; Anne W. Rutjes ; Bradley C. Johnston ; Stephan Reichenbach ; Sven Trelle ; Gordon H. Guyatt ; Peter J¨¹ni
- 关键词：Meta-analysis ; Change ; Follow-up ; Bias ; Continuous outcome ; Review
- 刊名：Journal of Clinical Epidemiology
- 出版年：2013
- 出版时间：August, 2013
- 年：2013
- 卷：66
- 期：8
- 页码：847-855
- 全文大小：247 K
class=""h4"">Objective
To investigate whether it is valid to combine follow-up and change data when conducting meta-analyses of continuous outcomes.class=""h4"">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).
class=""h4"">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.
class=""h4"">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.