Variability in meta-analysis estimates of continuous outcomes using different standardization and scale-specific re-expression methods
Variability in meta-analysis estimates of continuous outcomes using different standardization and scale-specific re-expression methods
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DOI：
10.1016/j.jclinepi.2023.11.003
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发表时间：
2023-12-03
影响因子：
7.2
通讯作者：
Dias，Sofia
中科院分区：
文献类型：
--
作者：
Gallardo-Gomez，Daniel;Pedder，Hugo;Dias，Sofia
目的探讨使用不同的数据标准化和尺度特异性重新表达方法（即，在使用标准化平均差（SMD）的荟萃分析中，将标准化数据转换为特定规模单位的过程）。研究设计和设置我们使用来自随机对照试验荟萃分析的短期身体表现测试和Barthel指数评估的数据，这些试验综合了身体活动对住院老年人功能能力有效性的证据。我们使用研究特定的合并标准差（SD）、内部和外部SD参考标准对数据进行标准化。对每种方法进行贝叶斯荟萃分析，以比较荟萃分析参数的后验分布。后验估计重新表示成规模特定的单位，采用不同的方法建立在科克伦guidelines. ResultsMeta分析估计依赖于所使用的标准化方法。包括使用最大SD参考标准化数据的分析显示，两种量表的估计值较低，不确定性较小。用于将SMD重新表达为尺度特定单位的方法影响了其后期临床解释。当使用相同的SD参考标准化和重新表达data.ConclusionDifferent数据标准化方法产生了不同的荟萃分析估计SMD规模时，获得了最相似的结果跨模型。为了避免引入偏倚，建议使用单个量表特定SD参考标准化数据，而不是研究特定的合并样本SD。因此，荟萃分析软件包可能会改变其默认方法，以允许通过单个量表特定SD进行该方法。为了将SMD重新表示为尺度特定单位，我们建议应用用于数据标准化的相同SD参考。
ObjectivesTo explore the impact of using different data standardization and scale-specific re-expression methods (i.e., processes to convert standardized data into scale-specific units) in meta-analyses using standardized mean differences (SMDs).Study Design and SettingWe used data assessed by the Short Physical Performance Battery and the Barthel Index from a meta-analysis of randomized controlled trials which synthesized evidence of physical activity effectiveness on the functional capacity of hospitalized older adults. We standardized the data using study-specific pooled standard deviations (SDs), an internal, and an external SD references. Bayesian meta-analyses were performed for each method to compare the posterior distributions of the meta-analysis parameters. Posterior estimates were re-expressed into scale-specific units applying different methods established in the Cochrane guidelines.ResultsMeta-analysis estimates depend on the used standardization method. Analyses including data standardized using the largest SD reference presented lower estimates with less uncertainty in both scales. The method applied for re-expressing SMDs into scale-specific units impacted in their posterior clinical interpretation. The most similar results across models were obtained when using the same SD reference to standardize and re-express data.ConclusionDifferent data standardization methods yielded different meta-analysis estimates on the SMD scale. To avoid the introduction of bias, the use of a single scale-specific SD reference to standardize data is recommended and instead of study-specific pooled sample SDs. Meta-analysis software packages may therefore change their default methods to allow this method by a single scale-specific SD. To re-express the SMDs into scale-specific units, we suggest the application of the same SD reference that was used for data standardization.