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Just How Plain Are Plain Tobacco Packs: Re-analysis of a Systematic Review Using Multilevel Meta-analysis Suggests Lessons About the Comparative Benefits of Synthesis Methods

Melendez-Torres, GJ; Thomas, J; Lorenc, T; O'Mara-Eves, A; Petticrew, M; (2018) Just How Plain Are Plain Tobacco Packs: Re-analysis of a Systematic Review Using Multilevel Meta-analysis Suggests Lessons About the Comparative Benefits of Synthesis Methods. Systematic Reviews , 7 (153) 10.1186/s13643-018-0821-7. Green open access

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Abstract

BACKGROUND: Comparisons between narrative synthesis and meta-analysis as synthesis methods in systematic reviews are uncommon within the same systematic review. We re-analysed a systematic review on the effects of plain packaging of tobacco on attractiveness. We sought to compare different synthesis approaches within the same systematic review and shed light on the comparative benefits of each approach. METHODS: In our re-analysis, we included results relating to attractiveness in included reports. We extracted findings from studies and converted all estimates of differences in attractiveness to Cohen's d. We used multilevel meta-analysis to account for clustering of effect sizes within studies. RESULTS: Of the 19 studies reporting results on attractiveness, seven studies that included between-subjects analyses could be included in the meta-analysis. Plain packs were less attractive than branded packs (d = - 0.59, 95% CI [- 0.71, - 0.47]), with negligible but uncertain between-studies heterogeneity (I2 = 0%, 95% CI [0.00, 70.81]) and high within-study heterogeneity (I2 = 92.6%, 95% CI [91.04, 93.90]). CONCLUSIONS: The meta-analysis found, similar to the narrative synthesis, that respondents typically rated plain packaging as less attractive than alternative (e.g. branded) tobacco packs. However, there were several trade-offs between analysis methods in the types and bodies of evidence each one contained and in the difference between partial precision and breadth of conclusions. Analysis methods were different in respect of the role of judgement and contextual variation and in terms of estimation and unexpected effect modification. In addition, we noted that analysis methods were different in how they accounted for heterogeneity and consistency.

Type: Article
Title: Just How Plain Are Plain Tobacco Packs: Re-analysis of a Systematic Review Using Multilevel Meta-analysis Suggests Lessons About the Comparative Benefits of Synthesis Methods
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s13643-018-0821-7
Publisher version: https://doi.org/10.1186/s13643-018-0821-7
Language: English
Additional information: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Meta-analysis, Narrative synthesis, Systematic review
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute
URI: https://discovery.ucl.ac.uk/id/eprint/10058739
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