Advances in the meta-analysis of heterogeneous clinical trials II: the quality effects model

Doi, Suhail A. R. and Barendregt, Jan J. and Khan, Shahjahan and Thalib, Lukman and Williams, Gail M. (2015) Advances in the meta-analysis of heterogeneous clinical trials II: the quality effects model. Contemporary Clinical Trials, 45 (A). pp. 123-129. ISSN 1551-7144


This article examines the performance of the updated quality effects (QE) estimator formeta-analysis of heterogeneous studies. It is shown that this approach leads to a decreased mean squared error (MSE) of the estimator
while maintaining the nominal level of coverage probability of the confidence interval. Extensive simulation
studies confirm that this approach leads to the maintenance of the correct coverage probability of the confidence
interval, regardless of the level of heterogeneity, as well as a lower observed variance compared to the random effects
(RE) model. The QE model is robust to subjectivity in quality assessment down to completely random entry,
in which case its MSE equals that of the RE estimator.When the proposed QEmethod is applied to ameta-analysis
of magnesium for myocardial infarction data, the pooled mortality odds ratio (OR) becomes 0.81 (95% CI 0.61–
1.08) which favors the larger studies but also reflects the increased uncertainty around the pooled estimate. In
comparison, under the RE model, the pooled mortality OR is 0.71 (95% CI 0.57–0.89) which is less conservative
than that of the QE results. The new estimation method has been implemented into the free meta-analysis software
MetaXL which allows comparison of alternative estimators and can be downloaded

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Permanent restricted access to Published version in accordance with the copyright policy of the publisher.
Faculty/School / Institute/Centre: Current - Faculty of Health, Engineering and Sciences - School of Agricultural, Computational and Environmental Sciences
Date Deposited: 07 Dec 2015 04:46
Last Modified: 15 Sep 2016 06:26
Uncontrolled Keywords: fixed effects; heterogeneity; meta-analysis; quasi-likelihood; quality effects; random effects
Fields of Research : 11 Medical and Health Sciences > 1199 Other Medical and Health Sciences > 119999 Medical and Health Sciences not elsewhere classified
01 Mathematical Sciences > 0104 Statistics > 010402 Biostatistics
Socio-Economic Objective: E Expanding Knowledge > 97 Expanding Knowledge > 970111 Expanding Knowledge in the Medical and Health Sciences
E Expanding Knowledge > 97 Expanding Knowledge > 970101 Expanding Knowledge in the Mathematical Sciences
Identification Number or DOI: 10.1016/j.cct.2015.05.010

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