Robustness assessments are needed to reduce bias in meta-analyses that include zero-event randomized trials

F Keus*, J Wetterslev, C Gluud, H G Gooszen, C J H M van Laarhoven

*Corresponding author voor dit werk

OnderzoeksoutputAcademicpeer review

77 Citaten (Scopus)

Samenvatting

OBJECTIVES: Meta-analysis of randomized trials with binary data can use a variety of statistical methods. Zero-event trials may create analytic problems. We explored how different methods may impact inferences from meta-analyses containing zero-event trials.

METHODS: Five levels of statistical methods are identified for meta-analysis with zero-event trials, leading to numerous data analyses. We used the binary outcomes from our Cochrane review of randomized trials of laparoscopic vs. small-incision cholecystectomy for patients with symptomatic cholecystolithiasis to illustrate the influence of statistical method on inference.

RESULTS: In seven meta-analyses of seven outcomes from 15 trials, there were zero-event trials in 0 to 71.4% of the trials. We found inconsistency in significance in one of seven outcomes (14%; 95% confidence limit 0.4%-57.9%). There was also considerable variability in the confidence limits, the intervention-effect estimates, and heterogeneity for all outcomes.

CONCLUSIONS: The statistical method may influence the inference drawn from a meta-analysis that includes zero-event trials. Robustness assessments are needed to reduce bias in meta-analyses that include zero-event trials.

Originele taal-2English
Pagina's (van-tot)546-51
Aantal pagina's6
TijdschriftThe American Journal of Gastroenterology
Volume104
Nummer van het tijdschrift3
DOI's
StatusPublished - mrt.-2009
Extern gepubliceerdJa

Vingerafdruk

Duik in de onderzoeksthema's van 'Robustness assessments are needed to reduce bias in meta-analyses that include zero-event randomized trials'. Samen vormen ze een unieke vingerafdruk.

Citeer dit