scholarly journals Allowing for uncertainty due to missing continuous outcome data in pairwise and network meta‐analysis

2015 ◽  
Vol 34 (5) ◽  
pp. 721-741 ◽  
Author(s):  
Dimitris Mavridis ◽  
Ian R. White ◽  
Julian P. T. Higgins ◽  
Andrea Cipriani ◽  
Georgia Salanti
Keyword(s):  
Meta Analysis ◽  
Outcome Data ◽  
Continuous Outcome

scholarly journals One‐stage random effects meta‐analysis using linear mixed models for aggregate continuous outcome data

2019 ◽  
Vol 10 (3) ◽  
pp. 360-375 ◽  
Author(s):  
Katerina Papadimitropoulou ◽  
Theo Stijnen ◽  
Olaf M. Dekkers ◽  
Saskia Cessie
Keyword(s):  
Random Effects ◽  
Mixed Models ◽  
Meta Analysis ◽  
Linear Mixed Models ◽  
Outcome Data ◽  
Continuous Outcome ◽  
One Stage

Meta-analysis of continuous outcome data from individual patients

2001 ◽  
Vol 20 (15) ◽  
pp. 2219-2241 ◽  
Author(s):  
Julian P. T. Higgins ◽  
Anne Whitehead ◽  
Rebecca M. Turner ◽  
Rumana Z. Omar ◽  
Simon G. Thompson
Keyword(s):  
Meta Analysis ◽  
Outcome Data ◽  
Continuous Outcome

scholarly journals Continuous(ly) missing outcome data in network meta-analysis: A one-stage pattern-mixture model approach

2021 ◽  
pp. 096228022098354
Author(s):  
Loukia M Spineli ◽  
Chrysostomos Kalyvas ◽  
Katerina Papadimitropoulou
Keyword(s):  
Mixture Model ◽  
Meta Analysis ◽  
Missing At Random ◽  
Outcome Data ◽  
Analysis Model ◽  
Continuous Outcome ◽  
Pattern Mixture Model ◽  
One Stage ◽  
Mixture Model Approach ◽  
Model Approach

Appropriate handling of aggregate missing outcome data is necessary to minimise bias in the conclusions of systematic reviews. The two-stage pattern-mixture model has been already proposed to address aggregate missing continuous outcome data. While this approach is more proper compared with the exclusion of missing continuous outcome data and simple imputation methods, it does not offer flexible modelling of missing continuous outcome data to investigate their implications on the conclusions thoroughly. Therefore, we propose a one-stage pattern-mixture model approach under the Bayesian framework to address missing continuous outcome data in a network of interventions and gain knowledge about the missingness process in different trials and interventions. We extend the hierarchical network meta-analysis model for one aggregate continuous outcome to incorporate a missingness parameter that measures the departure from the missing at random assumption. We consider various effect size estimates for continuous data, and two informative missingness parameters, the informative missingness difference of means and the informative missingness ratio of means. We incorporate our prior belief about the missingness parameters while allowing for several possibilities of prior structures to account for the fact that the missingness process may differ in the network. The method is exemplified in two networks from published reviews comprising a different amount of missing continuous outcome data.

In Reply: Dexamethasone Therapy For Bacterial Meningitis

PEDIATRICS ◽  
1996 ◽  
Vol 97 (2) ◽  
pp. 287-287 ◽  
Author(s):  
ELLEN R. WALD
Keyword(s):  
Bacterial Meningitis ◽  
Meta Analysis ◽  
Bacterial Species ◽  
The United States ◽  
Generation Cephalosporin ◽  
Outcome Data ◽  
Haemophilus Influenzae Type ◽  
Double Blind ◽  
Dexamethasone Therapy ◽  
Meningitis In Children

Dr Bonadio has combined outcome data from four prospective, randomized, double-blind, placebo-controlled trials assessing the effect of adjunctive corticosteroid therapy on the outcome of bacterial meningitis in children treated with a third-generation cephalosporin. Similar to the previously published meta-analysis included in the article by Schaad et al, Dr Bonadio's analysis includes all etiologies of bacterial meningitis without clarifying whether a beneficial effect applies to particular bacterial species. Fifty-two to 82% of cases in each of the trials were comprised of Haemophilus influenzae type b, a bacterial species that is now a rare cause of meningitis in the United States.

The use of high venous ligation as an adjunct to endovenous therapy in the management of great saphenous vein incompetence: A systematic review and meta-analysis of randomized controlled trials

2019 ◽  
Vol 34 (7) ◽  
pp. 433-444
Author(s):  
Thomas M Aherne ◽  
Mekki Medani ◽  
Shaheel Sahebally ◽  
Elrasheid Kheirelseid ◽  
Edward Mulkern ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Hybrid Approach ◽  
Outcome Data ◽  
Operative Intervention ◽  
Controlled Trials ◽  
Recurrence Rates ◽  
Randomized Controlled ◽  
Venous Surgery

Background In recent years, endovenous intervention has emerged as a minimally invasive alternative to open venous surgery. However, endovenous intervention does not formally disconnect the deep and superficial venous systems and it is hypothesized that recurrence may be greater in the absence of high venous ligation. This study aims to compare the efficacy of a hybrid endovenous approach with adjuvant high venous ligation and standard operative intervention in the management of great saphenous incompetence. Methods In March 2018, Medline and Embase were systematically searched for relevant randomized controlled trials. All randomized controlled trials comparing a hybrid approach with standard operative intervention were included. Studies were required to include at least one pre-defined outcome. Data were extracted and assessed by two independent reviewers. Pooled risk ratios were calculated using a random effects model. Additional subgroup analyses were performed. Results Eight randomized controlled trials including 1244 patients were analysed. Pooled standardized data revealed no difference in overall recurrence (pooled RR = 1.00 [95% CI = 0.57, 1.77]), major operative morbidity (RR = 0.43 [95% CI = 0.06, 2.89]), or re-interventions (RR = 0.94 [95% CI = 0.12, 7.24]) for the hybrid group compared with standard operative intervention alone. Subgroup analysis revealed comparable short-, medium- and long-term recurrence rates between both cohorts. Furthermore, no difference in recurrence was identified when the hybrid approach was compared to open surgery alone (RR = 1.01 [95% CI = 0.63, 1.61]) or endovenous monotherapy (RR = 0.67 [95% CI = 0.04, 12.24]). Conclusion The use of a hybrid approach in the management of great saphenous incompetence appears to offer no recurrence, re-intervention or morbidity benefit when compared to standard operative intervention.

scholarly journals Comparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Jie Zhang ◽  
Xingshun Qi ◽  
Fangfang Yi ◽  
Rongrong Cao ◽  
Guangrong Gao ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Clinical Efficacy ◽  
Da Vinci ◽  
Meta Analysis ◽  
Outcome Data ◽  
Intersphincteric Resection ◽  
Low Rectal Cancer ◽  
Cochrane Library ◽  
Alternative Choice ◽  
Laparoscopic Intersphincteric Resection

Background and Aims: The intersphincteric resection (ISR) is beneficial for saving patients' anus to a large extent and restoring original bowel continuity. Laparoscopic ISR (L-ISR) has its drawbacks, such as two-dimensional images, low motion flexibility, and unstable lens. Recently, da Vinci robotic ISR (R-ISR) is increasingly used worldwide. The purpose of this article is to compare the feasibility, safety, oncological outcomes, and clinical efficacy of R-ISR vs. L-ISR for low rectal cancer.Methods: PubMed, EMBASE, Cochrane Library, and Web of Science were searched to identify comparative studies of R-ISR vs. L-ISR. Demographic, clinical, and outcome data were extracted. Mean difference (MD) and risk ratio (RR) with their corresponding confidence intervals (CIs) were calculated.Results: Five studies were included. In total, 510 patients were included, of whom 273 underwent R-ISR and 237 L-ISR. Compared with L-ISR, R-ISR has significantly lower estimated intraoperative blood loss (MD = −23.31, 95% CI [−41.98, −4.64], P = 0.01), longer operative time (MD = 51.77, 95% CI [25.68, 77.86], P = 0.0001), hospitalization days (MD = −1.52, 95% CI [−2.10, 0.94], P < 0.00001), and postoperative urinary complications (RR = 0.36, 95% CI [0.16, 0.82], P = 0.02).Conclusions: The potential benefits of R-ISR are considered as a safe and feasible alternative choice for the treatment of low rectal tumors.

scholarly journals Biotic Supplements for Renal Patients: A Systematic Review and Meta-Analysis

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1224 ◽  
Author(s):  
Anna Pisano ◽  
Graziella D’Arrigo ◽  
Giuseppe Coppolino ◽  
Davide Bolignano
Keyword(s):  
Systematic Review ◽  
Large Scale ◽  
Meta Analysis ◽  
Outcome Data ◽  
Reactive Protein ◽  
Surrogate Outcomes ◽  
Ovid Medline ◽  
Primary Endpoints ◽  
Intestinal Dysbiosis ◽  
Secondary Endpoints

Intestinal dysbiosis is highly pervasive among chronic kidney disease (CKD) patients and may play a key role in disease progression and complications. We performed a systematic review and meta-analysis to evaluate effects of biotic supplements on a large series of outcomes in renal patients. Ovid-MEDLINE, PubMed and CENTRAL databases were searched for randomized controlled trials (RCTs) comparing any biotic (pre-, pro- or synbiotics) to standard therapy or placebo. Primary endpoints were change in renal function and cardiovascular events; secondary endpoints were change in proteinuria/albuminuria, inflammation, uremic toxins, quality of life and nutritional status. Seventeen eligible studies (701 participants) were reviewed. Biotics treatment did not modify estimated glomerular filtration rate (eGFR) (mean difference (MD) 0.34 mL/min/1.73 m2; 95% CI −0.19, 0.86), serum creatinine (MD −0.13 mg/dL; 95% confidence interval (CI) −0.32, 0.07), C-reactive protein (MD 0.75 mg/dL; 95% CI −1.54, 3.03) and urea (standardized MD (SMD) −0.02; 95% CI −0.25, 0.20) as compared to control. Outcome data on the other endpoints of interest were lacking, sparse or in an unsuitable format to be analyzed collectively. According to the currently available evidence, there is no conclusive rationale for recommending biotic supplements for improving outcomes in renal patients. Large-scale, well-designed and adequately powered studies focusing on hard rather than surrogate outcomes are still awaited.

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