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Two decades of network meta-analysis: Roadmap to their applications and challenges 网络荟萃分析二十年:其应用和挑战的路线图。
IF 5 2区 生物学 Q1 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2024-07-31 DOI: 10.1002/jrsm.1744
Areti Angeliki Veroniki, Ivan Florez, Brian Hutton, Sharon E. Straus, Andrea C. Tricco

Recently, Ades and colleagues discussed the controversies and advancements in network meta-analysis (NMA) over the past two decades, discussing its reliability, assumptions, novel approaches, and provided some useful recommendations for the conduction of NMAs. The present discussion paper builds on the insights by Ades and colleagues, providing a roadmap for NMA applications, advancements in software and tools, and approaches designed to facilitate the assessment and interpretation of NMA findings. It also discusses the impact of NMA across disciplines, particularly for policymakers and guideline developers. Despite 20 years of NMA history, challenges remain in understanding and assessing assumptions, communicating and interpreting findings, and applying common approaches like network meta-regression and NMA involving non-randomized studies in readily available software. NMA has proven particularly valuable in clinical decision-making, which highlights the need for additional training and interdisciplinary collaboration of knowledge users, including patient engagement, to enhance its adoption and address real-world problems.

最近,Ates 及其同事讨论了网络荟萃分析 (NMA) 在过去二十年中的争议和进步,讨论了其可靠性、假设、新方法,并为 NMA 的进行提供了一些有用的建议。本讨论文件以 Ades 及其同事的见解为基础,为 NMA 应用、软件和工具的进步以及旨在促进评估和解释 NMA 研究结果的方法提供了路线图。它还讨论了 NMA 对各学科的影响,尤其是对政策制定者和指南制定者的影响。尽管 NMA 已有 20 年的历史,但在理解和评估假设、交流和解释研究结果以及在现成软件中应用网络元回归和涉及非随机研究的 NMA 等常用方法方面仍存在挑战。事实证明,NMA 在临床决策中特别有价值,这就凸显出需要对知识使用者进行更多培训和跨学科合作,包括让患者参与进来,以提高其采用率并解决现实世界中的问题。
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引用次数: 0
‘Twenty years of network meta-analysis: Continuing controversies and recent developments’: A health technology assessment perspective 网络荟萃分析二十年:持续争议与最新发展":卫生技术评估的视角。
IF 5 2区 生物学 Q1 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2024-07-30 DOI: 10.1002/jrsm.1740
Dan Jackson, Landan Zhang, Robert Hettle, Miranda Cooper

We respond to some of the methodological issues raised in a recent review of network meta-analysis (NMA). We also provide a health technology developer's perspective and consider the future application of NMA to health technology assessment.

我们对近期网络荟萃分析 (NMA) 综述中提出的一些方法论问题做出了回应。我们还提供了卫生技术开发人员的观点,并考虑了 NMA 在卫生技术评估中的未来应用。
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引用次数: 0
Response to discussant comments on “NMA, the first 20 years” 对讨论者关于 "NMA,第一个 20 年 "的评论的回应。
IF 5 2区 生物学 Q1 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2024-07-26 DOI: 10.1002/jrsm.1745
A. E. Ades, Nicky J. Welton, Sofia Dias, Deborah M. Caldwell, David M. Phillippo

We respond to discussant comments on our paper “Twenty years of network meta-analysis: Continuing controversies and recent developments” (https://doi.org/10.1002/jrsm.1700) and raise some additional points for consideration, including: the way in which methodological guidance is generated; integration of the estimand framework with evidence synthesis; and implications of the European Joint Clinical Assessment. We ask: what properties are required of population adjustment methods to enable transparent and consistent decision-making? We also ask why individual patient data is not routinely made available to re-imbursement authorities and clinical guideline developers.

我们回应了讨论者对我们的论文 "网络荟萃分析二十年:持续争议与最新进展》(https://doi.org/10.1002/jrsm.1700) 的讨论意见,并提出了一些补充要点供参考,包括:方法论指导的产生方式;估计值框架与证据综合的整合;以及欧洲联合临床评估的影响。我们要问:人群调整方法需要具备哪些特性才能做出透明、一致的决策?我们还问:为什么不向报销机构和临床指南制定者例行提供个体患者数据?
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引用次数: 0
Network meta-analysis: Looping back 网络荟萃分析:回环
IF 5 2区 生物学 Q1 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2024-07-25 DOI: 10.1002/jrsm.1743
Thomas Lumley

This discussion contribution provides some subjective early history of network meta-analysis and also proposes a new bipartite graph structure to better represent multi-arm trials.

本讨论提供了一些网络荟萃分析的早期主观历史,还提出了一种新的双方图结构,以更好地表示多臂试验。
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引用次数: 0
Applying Bradford Hill to assessing causality in systematic reviews: A transparent approach using process tracing 应用 Bradford Hill 评估系统性综述中的因果关系:使用过程追踪的透明方法
IF 9.8 2区 生物学 Q1 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2024-06-22 DOI: 10.1002/jrsm.1730
Michal Shimonovich, Hilary Thomson, Anna Pearce, Srinivasa Vittal Katikireddi
BackgroundBradford Hill (BH) viewpoints are widely used to assess causality in systematic reviews, but their application has often lacked reproducibility. We describe an approach for assessing causality within systematic reviews (‘causal’ reviews), illustrating its application to the topic of income inequality and health. Our approach draws on principles of process tracing, a method used for case study research, to harness BH viewpoints to judge evidence for causal claims.MethodsIn process tracing, a hypothesis may be confirmed by observing highly unique evidence and disconfirmed by observing highly definitive evidence. We drew on these principles to consider the value of finding supportive or contradictory evidence for each BH viewpoint characterised by its uniqueness and definitiveness.ResultsIn our exemplar systematic review, we hypothesised that income inequality adversely affects self‐rated health and all‐cause mortality. BH viewpoints ‘analogy’ and ‘coherence’ were excluded from the causal assessment because of their low uniqueness and low definitiveness. The ‘experiment’ viewpoint was considered highly unique and highly definitive, and thus could be particularly valuable. We propose five steps for using BH viewpoints in a ‘causal’ review: (1) define the hypothesis; (2) characterise each viewpoint; (3) specify the evidence expected for each BH viewpoint for a true or untrue hypothesis; (4) gather evidence for each viewpoint (e.g., systematic review meta‐analyses, critical appraisal, background knowledge); (5) consider if each viewpoint was met (supportive evidence) or unmet (contradictory evidence).ConclusionsIncorporating process tracing has the potential to provide transparency and structure when using BH viewpoints in ‘causal’ reviews.
背景布拉德福德-希尔(BH)观点被广泛用于评估系统综述中的因果关系,但其应用往往缺乏可重复性。我们介绍了一种在系统性综述("因果 "综述)中评估因果关系的方法,并说明了该方法在收入不平等与健康这一主题中的应用。我们的方法借鉴了用于案例研究的过程追踪原则,利用BH观点来判断因果关系的证据。方法在过程追踪中,一个假设可能通过观察高度独特的证据而得到证实,也可能通过观察高度确定的证据而得不到证实。我们借鉴了这些原则,考虑为每种具有独特性和确定性特征的生物保健观点找到支持性或矛盾性证据的价值。结果在我们的示范性系统综述中,我们假设收入不平等会对自评健康和全因死亡率产生不利影响。由于 "类比 "和 "一致性 "观点的独特性和明确性较低,因此被排除在因果评估之外。实验 "观点被认为具有高度独特性和高度确定性,因此特别有价值。我们提出了在 "因果 "审查中使用生物保健观点的五个步骤:(结论在 "因果 "综述中使用生物保健观点时,纳入过程追踪有可能提供透明度和结构。
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引用次数: 0
Performance of two large language models for data extraction in evidence synthesis 两种大型语言模型在证据合成中提取数据的性能。
IF 5 2区 生物学 Q1 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2024-06-19 DOI: 10.1002/jrsm.1732
Amanda Konet, Ian Thomas, Gerald Gartlehner, Leila Kahwati, Rainer Hilscher, Shannon Kugley, Karen Crotty, Meera Viswanathan, Robert Chew

Accurate data extraction is a key component of evidence synthesis and critical to valid results. The advent of publicly available large language models (LLMs) has generated interest in these tools for evidence synthesis and created uncertainty about the choice of LLM. We compare the performance of two widely available LLMs (Claude 2 and GPT-4) for extracting pre-specified data elements from 10 published articles included in a previously completed systematic review. We use prompts and full study PDFs to compare the outputs from the browser versions of Claude 2 and GPT-4. GPT-4 required use of a third-party plugin to upload and parse PDFs. Accuracy was high for Claude 2 (96.3%). The accuracy of GPT-4 with the plug-in was lower (68.8%); however, most of the errors were due to the plug-in. Both LLMs correctly recognized when prespecified data elements were missing from the source PDF and generated correct information for data elements that were not reported explicitly in the articles. A secondary analysis demonstrated that, when provided selected text from the PDFs, Claude 2 and GPT-4 accurately extracted 98.7% and 100% of the data elements, respectively. Limitations include the narrow scope of the study PDFs used, that prompt development was completed using only Claude 2, and that we cannot guarantee the open-source articles were not used to train the LLMs. This study highlights the potential for LLMs to revolutionize data extraction but underscores the importance of accurate PDF parsing. For now, it remains essential for a human investigator to validate LLM extractions.

准确的数据提取是证据合成的关键组成部分,也是获得有效结果的关键。可公开获取的大型语言模型(LLM)的出现引起了人们对这些证据综合工具的兴趣,同时也为选择 LLM 带来了不确定性。我们比较了两种广泛使用的 LLM(Claude 2 和 GPT-4)在从先前完成的系统综述中收录的 10 篇已发表文章中提取预先指定的数据元素时的性能。我们使用提示和完整的研究 PDF 来比较 Claude 2 和 GPT-4 浏览器版本的输出结果。GPT-4 需要使用第三方插件来上传和解析 PDF。Claude 2 的准确率很高(96.3%)。使用插件的 GPT-4 的准确率较低(68.8%);不过,大部分错误是由插件造成的。两种 LLM 都能正确识别源 PDF 中缺少预先指定的数据元素,并为文章中未明确报告的数据元素生成正确的信息。二次分析表明,当提供 PDF 中的选定文本时,Claude 2 和 GPT-4 分别准确提取了 98.7% 和 100% 的数据元素。局限性包括:使用的研究 PDF 范围较窄;仅使用 Claude 2 完成了提示开发;我们无法保证开源文章未被用于训练 LLM。这项研究凸显了 LLM 在数据提取方面的革命性潜力,但同时也强调了精确 PDF 解析的重要性。目前,人类研究人员仍然有必要对 LLM 提取进行验证。
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引用次数: 0
Beyond Google Scholar, Scopus, and Web of Science: An evaluation of the backward and forward citation coverage of 59 databases' citation indices 超越 Google Scholar、Scopus 和 Web of Science:对 59 个数据库引文索引的前向和后向引文覆盖范围的评估。
IF 5 2区 生物学 Q1 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2024-06-14 DOI: 10.1002/jrsm.1729
Michael Gusenbauer

Citation indices providing information on backward citation (BWC) and forward citation (FWC) links are essential for literature discovery, bibliographic analysis, and knowledge synthesis, especially when language barriers impede document identification. However, the suitability of citation indices varies. While some have been analyzed, the majority, whether new or established, lack comprehensive evaluation. Therefore, this study evaluates the citation coverage of the citation indices of 59 databases, encompassing the widely used Google Scholar, Scopus, and Web of Science alongside many others never previously analyzed, such as the emerging Lens, Scite, Dimensions, and OpenAlex or the subject-specific PubMed and JSTOR. Through a comprehensive analysis using 259 journal articles from across disciplines, this research aims to guide scholars in selecting indices with broader document coverage and more accurate and comprehensive backward and forward citation links. Key findings highlight Google Scholar, ResearchGate, Semantic Scholar, and Lens as leading options for FWC searching, with Lens providing superior download capabilities. For BWC searching, the Web of Science Core Collection can be recommended over Scopus for accuracy. BWC information from publisher databases such as IEEE Xplore or ScienceDirect was generally found to be the most accurate, yet only available for a limited number of articles. The findings will help scholars conducting systematic reviews, meta-analyses, and bibliometric analyses to select the most suitable databases for citation searching.

提供后向引文(BWC)和前向引文(FWC)链接信息的引文索引对于文献发现、书目分析和知识合成至关重要,尤其是在语言障碍阻碍文献识别的情况下。然而,引文索引的适用性各不相同。虽然对一些索引进行了分析,但大多数索引,无论是新的还是已建立的,都缺乏全面的评估。因此,本研究评估了 59 个数据库的引文索引的引文覆盖范围,其中包括广泛使用的 Google Scholar、Scopus 和 Web of Science,以及许多以前从未分析过的其他数据库,如新兴的 Lens、Scite、Dimensions 和 OpenAlex 或特定主题的 PubMed 和 JSTOR。本研究通过对 259 篇跨学科期刊论文进行全面分析,旨在指导学者选择文献覆盖面更广、前后引文链接更准确、更全面的索引。主要研究结果表明,Google Scholar、ResearchGate、Semantic Scholar 和 Lens 是 FWC 搜索的主要选择,其中 Lens 的下载功能更胜一筹。在 BWC 搜索方面,推荐使用 Web of Science 核心合集,其准确性优于 Scopus。一般认为,IEEE Xplore 或 ScienceDirect 等出版商数据库中的 BWC 信息最为准确,但只能提供有限数量的文章。这些发现将有助于进行系统综述、荟萃分析和文献计量学分析的学者选择最合适的数据库进行引文检索。
{"title":"Beyond Google Scholar, Scopus, and Web of Science: An evaluation of the backward and forward citation coverage of 59 databases' citation indices","authors":"Michael Gusenbauer","doi":"10.1002/jrsm.1729","DOIUrl":"10.1002/jrsm.1729","url":null,"abstract":"<p>Citation indices providing information on backward citation (BWC) and forward citation (FWC) links are essential for literature discovery, bibliographic analysis, and knowledge synthesis, especially when language barriers impede document identification. However, the suitability of citation indices varies. While some have been analyzed, the majority, whether new or established, lack comprehensive evaluation. Therefore, this study evaluates the citation coverage of the citation indices of 59 databases, encompassing the widely used Google Scholar, Scopus, and Web of Science alongside many others never previously analyzed, such as the emerging Lens, Scite, Dimensions, and OpenAlex or the subject-specific PubMed and JSTOR. Through a comprehensive analysis using 259 journal articles from across disciplines, this research aims to guide scholars in selecting indices with broader document coverage and more accurate and comprehensive backward and forward citation links. Key findings highlight Google Scholar, ResearchGate, Semantic Scholar, and Lens as leading options for FWC searching, with Lens providing superior download capabilities. For BWC searching, the Web of Science Core Collection can be recommended over Scopus for accuracy. BWC information from publisher databases such as IEEE Xplore or ScienceDirect was generally found to be the most accurate, yet only available for a limited number of articles. The findings will help scholars conducting systematic reviews, meta-analyses, and bibliometric analyses to select the most suitable databases for citation searching.</p>","PeriodicalId":226,"journal":{"name":"Research Synthesis Methods","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jrsm.1729","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bayesian pairwise meta-analysis of time-to-event outcomes in the presence of non-proportional hazards: A simulation study of flexible parametric, piecewise exponential and fractional polynomial models 存在非比例危害的时间到事件结果的贝叶斯成对荟萃分析:灵活参数模型、分指数模型和分数多项式模型的模拟研究。
IF 5 2区 生物学 Q1 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2024-05-21 DOI: 10.1002/jrsm.1722
Suzanne C. Freeman, Alex J. Sutton, Nicola J. Cooper, Alessandro Gasparini, Michael J. Crowther, Neil Hawkins

Background

Traditionally, meta-analysis of time-to-event outcomes reports a single pooled hazard ratio assuming proportional hazards (PH). For health technology assessment evaluations, hazard ratios are frequently extrapolated across a lifetime horizon. However, when treatment effects vary over time, an assumption of PH is not always valid. The Royston-Parmar (RP), piecewise exponential (PE), and fractional polynomial (FP) models can accommodate non-PH and provide plausible extrapolations of survival curves beyond observed data.

Methods

Simulation study to assess and compare the performance of RP, PE, and FP models in a Bayesian framework estimating restricted mean survival time difference (RMSTD) at 50 years from a pairwise meta-analysis with evidence of non-PH. Individual patient data were generated from a mixture Weibull distribution. Twelve scenarios were considered varying the amount of follow-up data, number of trials in a meta-analysis, non-PH interaction coefficient, and prior distributions. Performance was assessed through bias and mean squared error. Models were applied to a metastatic breast cancer example.

Results

FP models performed best when the non-PH interaction coefficient was 0.2. RP models performed best in scenarios with complete follow-up data. PE models performed well on average across all scenarios. In the metastatic breast cancer example, RMSTD at 50-years ranged from −14.6 to 8.48 months.

Conclusions

Synthesis of time-to-event outcomes and estimation of RMSTD in the presence of non-PH can be challenging and computationally intensive. Different approaches make different assumptions regarding extrapolation and sensitivity analyses varying key assumptions are essential to check the robustness of conclusions to different assumptions for the underlying survival function.

背景:传统上,时间到事件结果的荟萃分析报告的是假设比例危险(PH)的单一汇总危险比。在卫生技术评估评价中,危害比经常被推断到整个生命周期。然而,当治疗效果随时间变化时,PH 假设并不总是有效的。罗伊斯顿-帕尔马模型(RP)、分项指数模型(PE)和分数多项式模型(FP)可以适应非PH值,并在观察数据之外提供可信的生存曲线外推:模拟研究:在贝叶斯框架中评估和比较 RP、PE 和 FP 模型的性能,从有证据表明非 PH 的配对荟萃分析中估计 50 岁时的受限平均生存时间差 (RMSTD)。单个患者数据由混合 Weibull 分布生成。考虑了 12 种不同的情况,包括随访数据量、荟萃分析中的试验数量、非 PH 交互系数和先验分布。通过偏差和均方误差评估其性能。模型被应用于转移性乳腺癌的实例中:当非 PH 交互系数为 0.2 时,FP 模型表现最佳。RP 模型在具有完整随访数据的情况下表现最佳。PE 模型在所有情况下平均表现良好。以转移性乳腺癌为例,50 年的 RMSTD 为 -14.6 到 8.48 个月不等:时间到事件结果的综合以及在非 PH 情况下 RMSTD 的估算具有挑战性,而且计算量很大。不同的方法会对外推法做出不同的假设,因此必须对不同的关键假设进行敏感性分析,以检查结论在基础生存函数的不同假设下的稳健性。
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引用次数: 0
The impact of continuity correction methods in Cochrane reviews with single-zero trials with rare events: A meta-epidemiological study 具有罕见事件的单项零试验的 Cochrane 综述中连续性校正方法的影响:一项元流行病学研究。
IF 5 2区 生物学 Q1 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2024-05-15 DOI: 10.1002/jrsm.1720
Yasushi Tsujimoto, Yusuke Tsutsumi, Yuki Kataoka, Akihiro Shiroshita, Orestis Efthimiou, Toshi A. Furukawa

Meta-analyses examining dichotomous outcomes often include single-zero studies, where no events occur in intervention or control groups. These pose challenges, and several methods have been proposed to address them. A fixed continuity correction method has been shown to bias estimates, but it is frequently used because sometimes software (e.g., RevMan software in Cochrane reviews) uses it as a default. We aimed to empirically compare results using the continuity correction with those using alternative models that do not require correction. To this aim, we reanalyzed the original data from 885 meta-analyses in Cochrane reviews using the following methods: (i) Mantel–Haenszel model with a fixed continuity correction, (ii) random effects inverse variance model with a fixed continuity correction, (iii) Peto method (the three models available in RevMan), (iv) random effects inverse variance model with the treatment arm continuity correction, (v) Mantel–Haenszel model without correction, (vi) logistic regression, and (vii) a Bayesian random effects model with binominal likelihood. For each meta-analysis we calculated ratios of odds ratios between all methods, to assess how the choice of method may impact results. Ratios of odds ratios <0.8 or <1.25 were seen in ~30% of the existing meta-analyses when comparing results between Mantel–Haenszel model with a fixed continuity correction and either Mantel–Haenszel model without correction or logistic regression. We concluded that injudicious use of the fixed continuity correction in existing Cochrane reviews may have substantially influenced effect estimates in some cases. Future updates of RevMan should incorporate less biased statistical methods.

研究二分法结果的元分析通常包括单零研究,即干预组或对照组均未发生任何事件。这就带来了挑战,并提出了几种方法来解决这些问题。固定连续性校正方法已被证明会使估计值出现偏差,但由于有时软件(如 Cochrane 综述中的 RevMan 软件)将其作为默认设置,因此该方法经常被使用。我们的目的是将使用连续性校正的结果与使用不需要校正的替代模型的结果进行实证比较。为此,我们采用以下方法重新分析了 Cochrane 综述中 885 项元分析的原始数据:(i) 带有固定连续性校正的 Mantel-Haenszel 模型,(ii) 带有固定连续性校正的随机效应逆方差模型,(iii) Peto 方法(RevMan 中提供的三种模型),(iv) 带有治疗臂连续性校正的随机效应逆方差模型,(v) 不带校正的 Mantel-Haenszel 模型,(vi) 逻辑回归,以及 (vii) 带有二项式可能性的贝叶斯随机效应模型。对于每项荟萃分析,我们都计算了所有方法之间的几率比,以评估方法的选择可能对结果产生的影响。几率比
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引用次数: 0
Combining endpoint and change data did not affect the summary standardised mean difference in pairwise and network meta-analyses: An empirical study in depression 合并终点数据和变化数据不会影响成对分析和网络荟萃分析中的汇总标准化平均差:抑郁症实证研究
IF 5 2区 生物学 Q1 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2024-05-09 DOI: 10.1002/jrsm.1719
Edoardo G. Ostinelli, Orestis Efthimiou, Yan Luo, Clara Miguel, Eirini Karyotaki, Pim Cuijpers, Toshi A. Furukawa, Georgia Salanti, Andrea Cipriani

When studies use different scales to measure continuous outcomes, standardised mean differences (SMD) are required to meta-analyse the data. However, outcomes are often reported as endpoint or change from baseline scores. Combining corresponding SMDs can be problematic and available guidance advises against this practice. We aimed to examine the impact of combining the two types of SMD in meta-analyses of depression severity. We used individual participant data on pharmacological interventions (89 studies, 27,409 participants) and internet-delivered cognitive behavioural therapy (iCBT; 61 studies, 13,687 participants) for depression to compare endpoint and change from baseline SMDs at the study level. Next, we performed pairwise (PWMA) and network meta-analyses (NMA) using endpoint SMDs, change from baseline SMDs, or a mixture of the two. Study-specific SMDs calculated from endpoint and change from baseline data were largely similar, although for iCBT interventions 25% of the studies at 3 months were associated with important differences between study-specific SMDs (median 0.01, IQR −0.10, 0.13) especially in smaller trials with baseline imbalances. However, when pooled, the differences between endpoint and change SMDs were negligible. Pooling only the more favourable of the two SMDs did not materially affect meta-analyses, resulting in differences of pooled SMDs up to 0.05 and 0.13 in the pharmacological and iCBT datasets, respectively. Our findings have implications for meta-analyses in depression, where we showed that the choice between endpoint and change scores for estimating SMDs had immaterial impact on summary meta-analytic estimates. Future studies should replicate and extend our analyses to fields other than depression.

当研究使用不同的量表来测量连续性结果时,需要使用标准化平均差(SMD)来对数据进行元分析。然而,研究结果通常以终点或与基线分数相比的变化进行报告。合并相应的 SMD 可能会有问题,现有指南建议不要这样做。我们的目的是研究在抑郁症严重程度的荟萃分析中合并两种类型的 SMD 的影响。我们使用了有关抑郁症药物干预(89 项研究,27409 名参与者)和互联网认知行为疗法(iCBT;61 项研究,13687 名参与者)的个人参与者数据,以比较研究水平上的终点 SMD 和基线变化 SMD。接下来,我们使用终点SMD、基线SMD变化或两者的混合进行了配对分析(PWMA)和网络荟萃分析(NMA)。根据终点数据和基线变化数据计算出的研究特异性 SMD 基本相似,但对于 iCBT 干预,25% 的研究在 3 个月时的研究特异性 SMD 之间存在重大差异(中位数为 0.01,IQR 为 -0.10,0.13),尤其是在基线不平衡的较小试验中。然而,在汇总时,终点和变化SMD之间的差异可以忽略不计。只汇集两个SMD中较有利的一个并不会对荟萃分析产生实质性影响,这导致药物治疗和iCBT数据集的汇集SMD差异分别达到0.05和0.13。我们的研究结果对抑郁症的荟萃分析具有启发意义,我们的研究表明,在估算SMD时选择终点和变化分数对荟萃分析的汇总估算结果影响不大。未来的研究应该复制我们的分析结果,并将其扩展到抑郁症以外的领域。
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引用次数: 0
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