scholarly journals Exact inference on the random‐effects model for meta‐analyses with few studies

Biometrics ◽  
2019 ◽  
Vol 75 (2) ◽  
pp. 485-493
Author(s):  
Haben Michael ◽  
Suzanne Thornton ◽  
Minge Xie ◽  
Lu Tian
Keyword(s):  
Random Effects ◽  
Random Effects Model ◽  
Exact Inference ◽  
Meta Analyses

The association of BMI and sarcopenia with survival in patients with glioblastoma multiforme

2021 ◽  
Author(s):  
Deniz Can Guven ◽  
Melek Seren Aksun ◽  
Ibrahim Yahya Cakir ◽  
Saadettin Kilickap ◽  
Neyran Kertmen
Keyword(s):  
Overall Survival ◽  
Body Composition ◽  
Glioblastoma Multiforme ◽  
Random Effects ◽  
Muscle Thickness ◽  
Pooled Analysis ◽  
Random Effects Model ◽  
Temporal Muscle ◽  
Inverse Variance ◽  
Meta Analyses

Background: The association between obesity and sarcopenia (via temporal muscle thickness) with overall survival (OS) has been evaluated in several glioblastoma multiforme studies, however, the data are inconclusive. Methods: The authors conducted meta-analyses via the generic inverse-variance method with a random-effects model. Results: In the pooled analysis of five studies, including 973 patients, patients with lower temporal muscle thickness had significantly decreased OS (HR: 1.62, 95% CI: 1.16–2.28, p = 0.005). The pooled analysis of five studies, including 2131 patients, demonstrated decreased OS in patients with lower BMI compared with patients with obesity (HR: 1.45, 95% CI: 1.12–1.88, p = 0.005). Conclusion: Readily available body composition parameters could be used for prognosis prediction and to aid in treatment decisions in patients with glioblastoma multiforme.

Systematic Review of Second Primary Oropharyngeal Cancers in Patients With p16+ Oropharyngeal Cancer

2020 ◽  
pp. 019459982095117
Author(s):  
Craig A. Bollig ◽  
David S. Lee ◽  
Angela L. Mazul ◽  
Katelyn Stepan ◽  
Sidharth V. Puram ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Random Effects ◽  
Meta Analysis ◽  
Second Primary ◽  
Random Effects Model ◽  
Treatment Information ◽  
Pooled Prevalence ◽  
Alive With Disease ◽  
Medical Librarian ◽  
Meta Analyses

Objective To systematically review the literature to determine the prevalence and clinical outcomes of second primary oropharyngeal squamous cell carcinoma (OPSCC). Data Sources Search strategies created with a medical librarian were implemented using multiple databases in October 2019. Review Methods The population of interest included adults age >18 years with a p16+ or human papillomavirus-positive OPSCC. The outcome was a synchronous or metachronous second primary OPSCC. Inclusion and exclusion criteria were designed to capture all study designs. In total, 685 records were identified by the search strategy. Two reviewers independently performed the review, extracted data, and performed a quality assessment. Primary Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A random-effects model was used for the meta-analysis. Results A total of 2470 patients with 35 second primary OPSCCs from 15 studies were identified. The pooled prevalence of second primary OPSCC was 1.4% (range, 0%-14.3%). In the random-effects model, the prevalence was estimated at 1.3% (95% CI, 0.7%-2.3%; P = .51, I2 = 52%). Of the 30 patients with treatment information, 26 (86.7%) received surgical treatment, while 4 (13.3%) underwent nonsurgical therapy. Of the 29 patients with available survival information, 22 (75.9%) had no evidence of disease at last follow-up, 5 (17.2%) ultimately died of disease, and 2 (6.9%) were alive with disease. Conclusion Overall, the rate of second primary OPSCC in patients with an index p16+ OPSCC is low, and most patients are successfully treated. Insufficient evidence currently exists to recommend routine elective tonsillectomy during surgical treatment of p16+ OPSCC.

Bivariate Random-effects Meta-analysis of Sensitivity and Specificity with SAS PROC GLIMMIX

2010 ◽  
Vol 49 (01) ◽  
pp. 54-64 ◽  
Author(s):  
J. Menke
Keyword(s):  
Sensitivity And Specificity ◽  
Random Effects ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Meta Analysis ◽  
Empirical Evaluation ◽  
Test Accuracy ◽  
Random Effects Model ◽  
Operating Characteristics ◽  
Meta Analyses

Summary Objectives: Meta-analysis allows to summarize pooled sensitivities and specificities from several primary diagnostic test accuracy studies. Often these pooled estimates are indirectly obtained from a hierarchical summary receiver operating characteristics (HSROC) analysis. This article presents a generalized linear random-effects model with the new SAS PROC GLIMMIX that obtains the pooled estimates for sensitivity and specificity directly. Methods: Firstly, the formula of the bivariate random-effects model is presented in context with the literature. Then its implementation with the new SAS PROC GLIMMIX is empirically evaluated in comparison to the indirect HSROC approach, utilizing the published 2 x 2 count data of 50 meta-analyses. Results: According to the empirical evaluation the meta-analytic results from the bivariate GLIMMIX approach are nearly identical to the results from the indirect HSROC approach. Conclusions: A generalized linear mixed model with PROC GLIMMIX offers a straightforward method for bivariate random-effects meta-analysis of sensitivity and specificity.

scholarly journals High burden of acute kidney injury in COVID-19 pandemic: systematic review and meta-analysis

2020 ◽  
pp. jclinpath-2020-207023
Author(s):  
Camila Barbosa Oliveira ◽  
Camilla Albertina Dantas Lima ◽  
Gisele Vajgel ◽  
Antonio Victor Campos Coelho ◽  
Paula Sandrin-Garcia
Keyword(s):  
Systematic Review ◽  
Acute Kidney Injury ◽  
Critically Ill ◽  
Random Effects ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Random Effects Model ◽  
Risk Of Death ◽  
Meta Analyses ◽  
The Impact

AimsHospitalised patients with COVID-19 have a variable incidence of acute kidney injury (AKI) according to studies from different nationalities. The present systematic review and meta-analysis describes the incidence of AKI, need for renal replacement therapy (RRT) and mortality among patients with COVID-19-associated AKI.MethodsWe systematically searched electronic database PubMed, SCOPUS and Web of Science to identify English articles published until 25 May 2020. In case of significant heterogeneity, the meta-analyses were conducted assuming a random-effects model.ResultsFrom 746 screened publications, we selected 21 observational studies with 15 536 patients with COVID-19 for random-effects model meta-analyses. The overall incidence of AKI was 12.3% (95% CI 7.3% to 20.0%) and 77% of patients with AKI were critically ill (95% CI 58.9% to 89.0%). The mortality among patients with AKI was 67% (95% CI 39.8% to 86.2%) and the risk of death was 13 times higher compared with patients without AKI (OR=13.3; 95% CI 6.1 to 29.2). Patients with COVID-19-associated AKI needed for RRT in 23.4% of cases (95% CI 12.6% to 39.4%) and those cases had high mortality (89%–100%).ConclusionThe present study evidenced an incidence of COVID-19-associated AKI higher than previous meta-analysis. The majority of patients affected by AKI were critically ill and mortality rate among AKI cases was high. Thus, it is extremely important for health systems to be aware about the impact of AKI on patients’ outcomes in order to establish proper screening, prevention of additional damage to the kidneys and adequate renal support when needed.

Surgical Outcomes of Endoscopic Versus Open Resection for Primary Sinonasal Malignancy: A Meta-analysis

2019 ◽  
Vol 33 (5) ◽  
pp. 608-616 ◽  
Author(s):  
Victor M. Lu ◽  
Krishnan Ravindran ◽  
Kevin Phan ◽  
Jamie J. Van Gompel ◽  
Timothy R. Smith ◽  
...  
Keyword(s):  
Random Effects ◽  
Surgical Outcomes ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Limited Evidence ◽  
Open Resection ◽  
Sinonasal Malignancies ◽  
Meta Analyses ◽  
Risk Ratios ◽  
Indirect Comparisons

Background Endoscopic resection (ER) for uncommon sinonasal malignancies (SNMs) has been reported to confer superior surgical outcomes compared to open resection (OR) based on indirect comparisons of limited evidence. Objective The aim of this study was to pool all direct comparative studies in the literature to validate this potential superior association. Methods Systematic searches of 7 electronic databases from their inception to April 2019 were conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. There were 1001 articles identified for screening. Outcomes of interest were pooled as risk ratios (RRs) and mean difference (MD) and analyzed using a random-effects model. Results There were 10 studies included in this meta-analysis, with 900 SNM patients in total where ER and OR were utilized in 399 (44%) and 501 (56%) cases, respectively. Compared to OR, random-effects (RE) modeling indicated ER resulted in statistically comparable complications (RR = 0.68; P-effect = .12) and recurrence (RR = 0.84; P-effect = .35). ER was associated with significantly shorter length of stay (LOS) compared to OR (MD = −2.9 days; P-effect <.01). Conclusions The use of ER to manage SNM was associated with significantly favorable reduction in LOS compared to OR. However, with respect to other surgical outcomes and recurrence, the current literature does not indicate either ER or OR as statistically superior. Therefore, until greater validation of these associations can be proven, expectations that ER for SNMs confers superior surgical outcomes compared to OR should be tempered.

scholarly journals Estimating required information size by quantifying diversity in random-effects model meta-analyses

2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Jørn Wetterslev ◽  
Kristian Thorlund ◽  
Jesper Brok ◽  
Christian Gluud
Keyword(s):  
Random Effects ◽  
Random Effects Model ◽  
Meta Analyses

scholarly journals Efficacy of Corticosteroids in Patients with SARS, MERS and COVID-19: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (8) ◽  
pp. 2392 ◽  
Author(s):  
Keum Hwa Lee ◽  
Sojung Yoon ◽  
Gwang Hun Jeong ◽  
Jong Yeob Kim ◽  
Young Joo Han ◽  
...  
Keyword(s):  
Systematic Review ◽  
Random Effects ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Control Group ◽  
Random Effects Model ◽  
Number Of Patients ◽  
Significant Difference ◽  
Meta Analyses ◽  
Coronavirus Infections

(1) Background: The use of corticosteroids in critical coronavirus infections, including severe acute respiratory syndrome (SARS), Middle East Respiratory Syndrome (MERS), or Coronavirus disease 2019 (COVID-19), has been controversial. However, a meta-analysis on the efficacy of steroids in treating these coronavirus infections is lacking. (2) Purpose: We assessed a methodological criticism on the quality of previous published meta-analyses and the risk of misleading conclusions with important therapeutic consequences. We also examined the evidence of the efficacy of corticosteroids in reducing mortality in SARS, MERS and COVID-19. (3) Methods: PubMed, MEDLINE, Embase, and Web of Science were used to identify studies published until 25 April 2020, that reported associations between steroid use and mortality in treating SARS/MERS/COVID-19. Two investigators screened and extracted data independently. Searches were restricted to studies on humans, and articles that did not report the exact number of patients in each group or data on mortality were excluded. We calculated odds ratios (ORs) or hazard ratios (HRs) under the fixed- and random-effect model. (4) Results: Eight articles (4051 patients) were eligible for inclusion. Among these selected studies, 3416 patients were diagnosed with SARS, 360 patients with MERS, and 275 with COVID-19; 60.3% patients were administered steroids. The meta-analyses including all studies showed no differences overall in terms of mortality (OR 1.152, 95% CI 0.631–2.101 in the random effects model, p = 0.645). However, this conclusion might be biased, because, in some studies, the patients in the steroid group had more severe symptoms than those in the control group. In contrast, when the meta-analysis was performed restricting only to studies that used appropriate adjustment (e.g., time, disease severity), there was a significant difference between the two groups (HR 0.378, 95% CI 0.221–0.646 in the random effects model, p < 0.0001). Although there was no difference in mortality when steroids were used in severe cases, there was a difference among the group with more underlying diseases (OR 3.133, 95% CI 1.670–5.877, p < 0.001). (5) Conclusions: To our knowledge, this study is the first comprehensive systematic review and meta-analysis providing the most accurate evidence on the effect of steroids in coronavirus infections. If not contraindicated, and in the absence of side effects, the use of steroids should be considered in coronavirus infection including COVID-19.

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