Handling incomplete correlated continuous and binary outcomes in meta-analysis of individual participant data.
Handling incomplete correlated continuous and binary outcomes in meta-analysis of individual participant data.
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DOI：
10.1002/sim.6969
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发表时间：
2016-09-20
影响因子：
2
通讯作者：
Normand SL
中科院分区：
文献类型：
--
作者：
Gomes M;Hatfield L;Normand SL
个体受试者数据（IPD）的Meta分析越来越多地用于改善治疗效果的估计，特别是在不同的受试者亚组中。IPD Meta分析中的一个重要问题与某些研究的部分或完全缺失结局有关，当关注多个离散和连续结局时，这个问题会加剧。当利用来自不同研究的不完全相关结局的信息时，充分观察的结局可能会提供有关其他结局不完整性的重要信息。在本文中，我们比较了IPD Meta分析中处理不完全连续和二元结果的两种模型：联合层次模型和一系列完全条件混合模型。我们说明了这些方法如何在解决缺失数据时纳入多个结局之间的相关性和研究间异质性。模拟测试了各种情况下方法的性能，这些情况根据缺失的比例和类型、结果之间的相关性强度和研究数量而有所不同。联合模型提供的置信区间覆盖率始终更接近名义水平，与所考虑的所有情景中的完全条件方法相比，均方误差更低。方法在随机对照试验的Meta分析中进行了说明，这些试验比较了单独使用植入式心律转复除颤器与植入式心律转复除颤器联合心脏复律治疗治疗慢性心力衰竭患者的有效性。© 2016作者。出版社：John Wiley & Sons Ltd
Meta‐analysis of individual participant data (IPD) is increasingly utilised to improve the estimation of treatment effects, particularly among different participant subgroups. An important concern in IPD meta‐analysis relates to partially or completely missing outcomes for some studies, a problem exacerbated when interest is on multiple discrete and continuous outcomes. When leveraging information from incomplete correlated outcomes across studies, the fully observed outcomes may provide important information about the incompleteness of the other outcomes. In this paper, we compare two models for handling incomplete continuous and binary outcomes in IPD meta‐analysis: a joint hierarchical model and a sequence of full conditional mixed models. We illustrate how these approaches incorporate the correlation across the multiple outcomes and the between‐study heterogeneity when addressing the missing data. Simulations characterise the performance of the methods across a range of scenarios which differ according to the proportion and type of missingness, strength of correlation between outcomes and the number of studies. The joint model provided confidence interval coverage consistently closer to nominal levels and lower mean squared error compared with the fully conditional approach across the scenarios considered. Methods are illustrated in a meta‐analysis of randomised controlled trials comparing the effectiveness of implantable cardioverter‐defibrillator devices alone to implantable cardioverter‐defibrillator combined with cardiac resynchronisation therapy for treating patients with chronic heart failure. © 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.