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Pooling systematic reviews of systematic reviews : a Bayesian panoramic meta-analysis
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Hemming, Karla, Bowater, Russell James and Lilford, Richard (2012) Pooling systematic reviews of systematic reviews : a Bayesian panoramic meta-analysis. Statistics in Medicine, 31 (3). pp. 201-216. doi:10.1002/sim.4372 ISSN 0277-6715.
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Official URL: http://dx.doi.org/10.1002/sim.4372
Abstract
Systematic reviews and meta-analyses usually synthesise evidence from studies reporting outcomes from particular interventions in specific diseases. For example, a meta-analysis of prophylactic antibiotics (intervention) in elective arterial reconstruction (disease) for rates of wound infection (outcome). However, because systematic reviews and meta-analyses are so widespread, a body of evidence often exists around specific intervention effects on particular outcomes over a range of diseases. So for example, a multitude of independent meta-analyses have evaluated rates of wound infection with and without the use of prophylactic antibiotics over multiple surgery types. A systematic review of systematic reviews is a means of synthesising evidence for the same intervention over multiple disease types. We propose a panoramic meta-analysis as a means of pooling effect estimates over systematic reviews of systematic reviews. We explore several methods ranging from a simple two-step approach, to a meta-regression or mixed effects approach, where variation between diseases are modelled as fixed covariate effects and between-study variation by random effects, and to a three-level hierarchical model in which exchangeability is assumed, which allows both a between-disease component of variance and a between-study (within disease) component of variance. In the surgery example, we pool 18 meta-analyses (each including between 4 and 26 studies) of prophylactic antibiotics reporting rates of wound infection from 18 different surgery sites to obtain a single pooled estimate of effect and estimates of between-disease, within-disease and within-study variability. Copyright © 2011 John Wiley & Sons, Ltd.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) | ||||
Journal or Publication Title: | Statistics in Medicine | ||||
Publisher: | John Wiley & Sons Ltd. | ||||
ISSN: | 0277-6715 | ||||
Official Date: | 2012 | ||||
Dates: |
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Volume: | 31 | ||||
Number: | 3 | ||||
Page Range: | pp. 201-216 | ||||
DOI: | 10.1002/sim.4372 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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