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The choice and definition of summary measure for meta-analysis of clinical studies with binary outcomes: Effect on clinical interpretation

Plumb, A; Halligan, S; Mallett, S; (2020) The choice and definition of summary measure for meta-analysis of clinical studies with binary outcomes: Effect on clinical interpretation. British Journal of Radiology , 93 (1108) , Article 20190976. 10.1259/bjr.20190976. Green open access

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Abstract

Many systematic reviews and meta-analyses concern the effect of a healthcare intervention on a binary outcome i.e. occurrence (or not) of a particular event. Usually, the overall effect, pooled across all studies included in the meta-analysis, is summarised using the odds ratio (OR) or the relative risk (RR). Under most circumstances, it is obvious how to identify what should be considered as the event of interest - for example, death or a clinically-important side-effect. However, on occasion it may not be clear in which "direction" the event should be specified - such as attendance ( vs non-attendance) at cancer screening. Usually, this choice is not critical to the overall conclusion of the meta-analysis, but occasionally it can lead to differences in how the included studies are pooled, ultimately affecting the overall meta-analytic result, particularly when using relative risks rather than odds ratios. In this commentary, we will explain this phenomenon in more detail using examples from the literature, and explore how analysts and readers can avoid some potential pitfalls.

Type: Article
Title: The choice and definition of summary measure for meta-analysis of clinical studies with binary outcomes: Effect on clinical interpretation
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1259/bjr.20190976
Publisher version: http://dx.doi.org/10.1259/bjr.20190976
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
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 Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Department of Imaging
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Experimental and Translational Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10090669
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