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 Research Synthesis Methods 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
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引用次数: 0

摘要

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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Combining endpoint and change data did not affect the summary standardised mean difference in pairwise and network meta-analyses: An empirical study in depression

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.

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来源期刊
Research Synthesis Methods
Research Synthesis Methods MATHEMATICAL & COMPUTATIONAL BIOLOGYMULTID-MULTIDISCIPLINARY SCIENCES
CiteScore
16.90
自引率
3.10%
发文量
75
期刊介绍: Research Synthesis Methods is a reputable, peer-reviewed journal that focuses on the development and dissemination of methods for conducting systematic research synthesis. Our aim is to advance the knowledge and application of research synthesis methods across various disciplines. Our journal provides a platform for the exchange of ideas and knowledge related to designing, conducting, analyzing, interpreting, reporting, and applying research synthesis. While research synthesis is commonly practiced in the health and social sciences, our journal also welcomes contributions from other fields to enrich the methodologies employed in research synthesis across scientific disciplines. By bridging different disciplines, we aim to foster collaboration and cross-fertilization of ideas, ultimately enhancing the quality and effectiveness of research synthesis methods. Whether you are a researcher, practitioner, or stakeholder involved in research synthesis, our journal strives to offer valuable insights and practical guidance for your work.
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