Combining multiple outcome measures in a meta-analysis:: an application
Combining multiple outcome measures in a meta-analysis:: an application
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DOI：
10.1002/sim.1370
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发表时间：
2003-04-30
影响因子：
2
通讯作者：
Stijnen, T
中科院分区：
文献类型：
--
作者：
Arends, LR;Vok贸, Z;Stijnen, T
在医学文献中发表的临床试验的荟萃分析中，通常将自己限制为标准的单变量固定或随机效应模型。如果存在多个端点，则分别分析每个端点。有关多种结果指标的多元方法的统计文献中，已经写了一些文章。但是，这些方法在实践中并不容易应用，因为必须使用自编写的程序，示例仅是二维的。在本文中，我们考虑了对中风风险增加的保守治疗的荟萃分析，对中风风险增加的保守治疗对手术无中风生存的影响。每次试验提供三项摘要措施：手术组的短期术后发病率/死亡率；手术组的长期事件率和保守组的事件率。我们与一般线性混合模型共同分析了这三个结果，将结果与标准单变量方法进行了比较，并讨论了多变量建模的许多优势。事实证明，通用线性混合模型是多元荟萃分析的非常方便的框架。所有分析均可在标准通用线性混合模型软件中进行。版权（C）2003 John Wiley Sons，Ltd。
In meta-analysis of clinical trials published in the medical literature it is customary to restrict oneself to standard univariate fixed or random effects models. If multiple endpoints are present, each endpoint is analysed separately. A few articles have been written in the statistical literature on multivariate methods for multiple outcome measures. However, these methods were not easy to apply in practice, because self-written programs had to be used, and the examples were only two-dimensional. In this paper we consider a meta-analysis on the effect on stroke-free survival of surgery compared to conservative treatment in patients with increased risk of stroke. Three summary measures per trial are available: short-term post-operative morbidity/mortality in the surgical group; long-term event rate in the surgical group, and the event rate in the conservative group. We analyse the three outcomes jointly with a general linear MIXED model, compare the results with the standard univariate approaches and discuss the many advantages of multivariate modelling. It turns out that the general linear MIXED model is a very convenient framework for multivariate meta-analysis. All analyses could be carried out in standard general linear MIXED model software. Copyright (C) 2003 John Wiley Sons, Ltd.