Rhodes, KM;
Savović, J;
Elbers, R;
Jones, HE;
Higgins, JPT;
Sterne, JAC;
Welton, NJ;
(2019)
Adjusting trial results for biases in meta‐analysis: combining data‐based evidence on bias with detailed trial assessment.
Journal of the Royal Statistical Society: Series A (Statistics in Society)
10.1111/rssa.12485.
(In press).
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Abstract
Flaws in the conduct of randomized trials can lead to biased estimation of the intervention effect. Methods for adjustment of within‐trial biases in meta‐analysis include the use of empirical evidence from an external collection of meta‐analyses, and the use of expert opinion informed by the assessment of detailed trial information. Our aim is to present methods to combine these two approaches to gain the advantages of both. We make use of the risk of bias information that is routinely available in Cochrane reviews, by obtaining empirical distributions for the bias associated with particular bias profiles (combinations of risk of bias judgements). We propose three methods: a formal combination of empirical evidence and opinion in a Bayesian analysis; asking experts to give an opinion on bias informed by both summary trial information and a bias distribution from the empirical evidence, either numerically or by selecting areas of the empirical distribution. The methods are demonstrated through application to two example binary outcome meta‐analyses. Bias distributions based on opinion informed by trial information alone were most dispersed on average, and those based on opinions obtained by selecting areas of the empirical distribution were narrowest. Although the three methods for combining empirical evidence with opinion vary in ease and speed of implementation, they yielded similar results in the two examples.
| Type: | Article |
|---|---|
| Title: | Adjusting trial results for biases in meta‐analysis: combining data‐based evidence on bias with detailed trial assessment |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/rssa.12485 |
| Publisher version: | https://doi.org/10.1111/rssa.12485 |
| Language: | English |
| Additional information: | Copyright © 2019 The Authors Journal of the Royal Statistical Society: Series A (Statistics in Society) published by John Wiley & Sons Ltd on behalf of Royal Statistical Society. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Bias, Elicitation, Meta‐analysis, Meta‐epidemiology, Randomized controlled 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/10077690 |
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