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Meta Analysis

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Mukta Sraj
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4 views18 pages

Meta Analysis

Uploaded by

Mukta Sraj
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Meta Analysis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC529799
Study sample
Study title
(20-40)

10

50

70
Definition

Meta-analysis is a quantitative approach


for systematically combining results of
previous research to arrive at conclusions
about the body of research
Karl Pearson is the first
medical researcher to use
formal techniques to combine
data from different studies
(1904)

He synthesised data from


several studies on efficacy of
typhoid vaccination
Traditional Systemic
Meta analysis
review review

Author Individual Team Team

Search
Individual Protocol based Protocol based
strategy

Summary
Authors Can be
Results statistical
judgement qualitative
technique
Terms you should
know
Publication bias - When only Published
data is taken which is 5% of the total
actual research

Heterogeneity - Variation between study


results because of any one of the PICO
elements or the difference in the quality
of the studies
Assessing quality of the studies

Jadad scale- Oxford quality scoring system, is a procedure to


independently assess the methodological quality of a clinical
trial
What is the weighting studies
and how it is done

Assessing which studies are more important

How - which give us more information

More participants

More events

Lower variance
Steps in meta analysis
Formulation of the research question

PICO model (Population, Intervention, Comparison,


Outcome)

Search of literature

Selection of studies

Decide which dependent variables or summary measures are


allowed.

Selection of a meta-analysis model

Examine sources of between-study heterogeneity


More deaths in
Adding up the studies gave - the steroids
For example : in the studies with steroids group
adding up the results of the studies - 34.3% in steroids group and 32.5%
301/925 in the control group with no in non steroids group
steroids died and in steroids group Thus the relative risk comes out to
410/1194 died
be - 1.06

Break
s dow
n
rando the powe Why follow so
miza r of
ti o n many steps and
not just add up the
result of previous
studies?
b a la n c e s the trials
Im

a b ias
u c es
d Lower deaths in
Intro the steroids
group

But if the meta analytic methods


implemented - Relative risk was
0.96
Models

Direct evidence: Models incorporating


study effects only

Fixed effects model

Random effects model

IVhet model
Models

Direct evidence: Models incorporating


additional information

Quality effects model


Models
Indirect evidence: Network meta-analysis
methods

Bayesian framework

Frequentist multivariate framework

Generalized pairwise modelling framework

Tailored meta-analysis

Aggregating IPD and AD


Fixed effect models

Fixed effects model assumes that the true


effect of treatment is the same value in each
study (fixed); the differences between studies
is solely due to random error (same
population, use the same variable and
outcome definitions, etc)

Provides a weighted average of a series of


study estimates
Mantel- Haenszel method (Relative risk
and odd’s ratio)

Peto‟s method (combining odds ratios )

Maximum-Likelihood techniques

Exact methods of interval estimation


Random effect models

In random effects models, the treatment


effects for the individual studies are
assumed to vary around some overall
average treatment effect
Weighted least squares

Un-weighted least squares

Maximum likelihood

Restricted Maximum likelihood

Exact approach to random effects of


binary data.

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