Conceptual, statistical and clinical interpretation of results from: Cryosurgery combined with topical interventions for actinic keratosis: a systematic review and meta‐analysis

2019 ◽  
Vol 181 (2) ◽  
pp. 423-424 ◽  
Author(s):  
R. Jayaraj ◽  
C. Kumarasamy
Keyword(s):  
Systematic Review ◽  
Actinic Keratosis ◽  
Meta Analysis ◽  
Clinical Interpretation ◽  
Interpretation Of Results

scholarly journals Using a distribution-based approach and systematic review methods to derive minimum clinically important differences

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jennifer A. Watt ◽  
Areti Angeliki Veroniki ◽  
Andrea C. Tricco ◽  
Sharon E. Straus
Keyword(s):  
Systematic Review ◽  
Treatment Effects ◽  
Meta Analysis ◽  
Minimum Clinically Important Difference ◽  
Disease Assessment ◽  
Future Research ◽  
Clinical Interpretation ◽  
Analytic Treatment ◽  
Clinical Scenarios ◽  
Using Data

Abstract Background Clinical interpretation of changes measured on a scale is dependent on knowing the minimum clinically important difference (MCID) for that scale: the threshold above which clinicians, patients, and researchers perceive an outcome difference. Until now, approaches to determining MCIDs were based upon individual studies or surveys of experts. However, the comparison of meta-analytic treatment effects to a MCID derived from a distribution of standard deviations (SDs) associated with all trial-specific outcomes in a meta-analysis could improve our clinical understanding of meta-analytic treatment effects. Methods We approximated MCIDs using a distribution-based approach that pooled SDs associated with baseline mean or mean change values for two scales (i.e. Mini-Mental State Exam [MMSE] and Alzheimer Disease Assessment Scale – Cognitive Subscale [ADAS-Cog]), as reported in parallel randomized trials (RCTs) that were included in a systematic review of cognitive enhancing medications for dementia (i.e. cholinesterase inhibitors and memantine). We excluded RCTs that did not report baseline or mean change SD values. We derived MCIDs at 0.4 and 0.5 SDs of the pooled SD and compared our derived MCIDs to previously published MCIDs for the MMSE and ADAS-Cog. Results We showed that MCIDs derived from a distribution-based approach approximated published MCIDs for the MMSE and ADAS-Cog. For the MMSE (51 RCTs, 12,449 patients), we derived a MCID of 1.6 at 0.4 SDs and 2 at 0.5 SDs using baseline SDs and we derived a MCID of 1.4 at 0.4 SDs and 1.8 at 0.5 SDs using mean change SDs. For the ADAS-Cog (37 RCTs, 10,006 patients), we derived a MCID of 4 at 0.4 SDs and 5 at 0.5 SDs using baseline SDs and we derived a MCID of 2.6 at 0.4 SDs and 3.2 at 0.5 SDs using mean change SDs. Conclusion A distribution-based approach using data included in a systematic review approximated known MCIDs. Our approach performed better when we derived MCIDs from baseline as opposed to mean change SDs. This approach could facilitate clinical interpretation of outcome measures reported in RCTs and systematic reviews of interventions. Future research should focus on the generalizability of this method to other clinical scenarios.

Interventions for Actinic Keratosis in Nonscalp and Nonface Localizations: Results from a Systematic Review with Network Meta-Analysis

2020 ◽  
Author(s):  
Theresa Steeb ◽  
Anja Wessely ◽  
Lutz Schmitz ◽  
Franz Heppt ◽  
Michael C. Kirchberger ◽  
...  
Keyword(s):  
Systematic Review ◽  
Actinic Keratosis ◽  
Meta Analysis

scholarly journals Cryosurgery combined with topical interventions for actinic keratosis: a systematic review and meta‐analysis

2018 ◽  
Vol 180 (4) ◽  
pp. 740-748 ◽  
Author(s):  
M.V. Heppt ◽  
T. Steeb ◽  
T. Ruzicka ◽  
C. Berking
Keyword(s):  
Systematic Review ◽  
Actinic Keratosis ◽  
Meta Analysis

scholarly journals Field Treatments for Actinic Keratosis: A Systematic Review and Network Meta-Analysis

2021 ◽  
Vol 5 (6) ◽  
pp. s81
Author(s):  
G Martin ◽  
B Berman ◽  
S Feldman ◽  
A Armstrong ◽  
M Edwards ◽  
...  
Keyword(s):  
Systematic Review ◽  
Actinic Keratosis ◽  
Meta Analysis

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