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Between-trial heterogeneity in meta-analyses may be partially explained by reported design characteristics

Rhodes, KM; Turner, RM; Savović, J; Jones, HE; Mawdsley, D; Higgins, JPT; (2018) Between-trial heterogeneity in meta-analyses may be partially explained by reported design characteristics. Journal of Clinical Epidemiology , 95 pp. 45-54. 10.1016/j.jclinepi.2017.11.025. Green open access

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Abstract

OBJECTIVE: We investigated the associations between risk of bias judgments from Cochrane reviews for sequence generation, allocation concealment and blinding and between-trial heterogeneity. STUDY DESIGN AND SETTING: Bayesian hierarchical models were fitted to binary data from 117 meta-analyses, to estimate the ratio λ by which heterogeneity changes for trials at high/unclear risk of bias, compared to trials at low risk of bias. We estimated the proportion of between-trial heterogeneity in each meta-analysis that could be explained by the bias associated with specific design characteristics. RESULTS: Univariable analyses showed that heterogeneity variances were, on average, increased among trials at high/unclear risk of bias for sequence generation (λˆ 1.14, 95% interval: 0.57 to 2.30) and blinding (λˆ 1.74, 95% interval: 0.85 to 3.47). Trials at high/unclear risk of bias for allocation concealment were on average less heterogeneous (λˆ 0.75, 95% interval: 0.35 to 1.61). Multivariable analyses showed that a median of 37% (95% interval: 0% to 71%) heterogeneity variance could be explained by trials at high/unclear risk of bias for sequence generation, allocation concealment and/or blinding. All 95% intervals for changes in heterogeneity were wide and included the null of no difference. CONCLUSION: Our interpretation of the results is limited by imprecise estimates. There is some indication that between-trial heterogeneity could be partially explained by reported design characteristics, and hence adjustment for bias could potentially improve accuracy of meta-analysis results.

Type: Article
Title: Between-trial heterogeneity in meta-analyses may be partially explained by reported design characteristics
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jclinepi.2017.11.025
Publisher version: https://doi.org/10.1016/j.jclinepi.2017.11.025
Language: English
Additional information: Crown Copyright ©� 2017. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Meta-analysis, Heterogeneity, Sequence generation, Allocation concealment, Blinding, Randomized trials
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10044458
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