Rhodes, KM;
Turner, RM;
Savović, J;
Jones, HE;
Mawdsley, D;
Higgins, JPT;
(2018)
Between-trial heterogeneity in meta-analyses may be partially explained by reported design characteristics.
Journal of Clinical Epidemiology
, 95
pp. 45-54.
10.1016/j.jclinepi.2017.11.025.
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Abstract
OBJECTIVE: We investigated the associations between risk of bias judgments from Cochrane reviews for sequence generation, allocation concealment and blinding and between-trial heterogeneity. STUDY DESIGN AND SETTING: Bayesian hierarchical models were fitted to binary data from 117 meta-analyses, to estimate the ratio λ by which heterogeneity changes for trials at high/unclear risk of bias, compared to trials at low risk of bias. We estimated the proportion of between-trial heterogeneity in each meta-analysis that could be explained by the bias associated with specific design characteristics. RESULTS: Univariable analyses showed that heterogeneity variances were, on average, increased among trials at high/unclear risk of bias for sequence generation (λˆ 1.14, 95% interval: 0.57 to 2.30) and blinding (λˆ 1.74, 95% interval: 0.85 to 3.47). Trials at high/unclear risk of bias for allocation concealment were on average less heterogeneous (λˆ 0.75, 95% interval: 0.35 to 1.61). Multivariable analyses showed that a median of 37% (95% interval: 0% to 71%) heterogeneity variance could be explained by trials at high/unclear risk of bias for sequence generation, allocation concealment and/or blinding. All 95% intervals for changes in heterogeneity were wide and included the null of no difference. CONCLUSION: Our interpretation of the results is limited by imprecise estimates. There is some indication that between-trial heterogeneity could be partially explained by reported design characteristics, and hence adjustment for bias could potentially improve accuracy of meta-analysis results.
| Type: | Article |
|---|---|
| Title: | Between-trial heterogeneity in meta-analyses may be partially explained by reported design characteristics |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jclinepi.2017.11.025 |
| Publisher version: | https://doi.org/10.1016/j.jclinepi.2017.11.025 |
| Language: | English |
| Additional information: | Crown Copyright ©� 2017. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | Meta-analysis, Heterogeneity, Sequence generation, Allocation concealment, Blinding, Randomized trials |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10044458 |
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