对用于(个体患者数据)荟萃分析中研究亚组的分析方法的系统评价。

A systematic review of analytical methods used to study subgroups in (individual patient data) meta-analyses.

作者信息

Koopman Laura, van der Heijden Geert J M G, Glasziou Paul P, Grobbee Diederick E, Rovers Maroeska M

机构信息

Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, Stratenum 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands.

出版信息

J Clin Epidemiol. 2007 Oct;60(10):1002-9. doi: 10.1016/j.jclinepi.2007.01.018. Epub 2007 Aug 1.

Abstract

OBJECTIVES

To determine whether individual patient data meta-analyses (IPDMA) are used to perform subgroup analyses and to study whether the analytical methods regarding subgroup analyses differ between IPDMA and conventional meta-analyses (CMA).

STUDY DESIGN AND SETTING

IPDMA were identified with a comprehensive literature search, subsequently, CMA on similar research questions were traced. Methods for studying subgroups were compared for IPDMA and CMA that were matched with respect to domain, type of treatment, and outcome measure.

RESULTS

Of all 171 identified IPDMA and 102 CMA, 80% and 45% presented subgroup analyses, respectively. For 35 IPDMA and 37 "matched" CMA, subgroup analytic methods could be compared. The number of performed subgroup analyses did not differ between IPDMA and CMA. Both IPDMA and CMA often do not report adequate information on methods of analyses. Interaction tests were often not performed in IPDMA (69%) and individual patient data was often not directly modelled (74%).

CONCLUSION

Many IPDMA performed subgroup analyses, but overall treatment effects were more emphasized than subgroup effects. To study subgroups, a wide variety of analytical methods was used in both IPDMA and CMA. In general, the use and reporting of appropriate methods for subgroup analyses should be promoted. Recommendations for improvement of methods of analyses are provided.

摘要

目的

确定个体患者数据荟萃分析(IPDMA)是否用于进行亚组分析,并研究IPDMA与传统荟萃分析(CMA)在亚组分析的分析方法上是否存在差异。

研究设计与背景

通过全面的文献检索确定IPDMA,随后追踪针对类似研究问题的CMA。比较了在领域、治疗类型和结局测量方面相匹配的IPDMA和CMA研究亚组的方法。

结果

在所有171项确定的IPDMA和102项CMA中,分别有80%和45%进行了亚组分析。对于35项IPDMA和37项“匹配”的CMA,可以比较亚组分析方法。IPDMA和CMA进行的亚组分析数量没有差异。IPDMA和CMA通常都没有报告关于分析方法的充分信息。IPDMA中常常不进行交互检验(69%),并且常常不直接对个体患者数据进行建模(74%)。

结论

许多IPDMA进行了亚组分析,但总体治疗效果比亚组效果更受重视。为了研究亚组,IPDMA和CMA都使用了各种各样的分析方法。总体而言,应促进亚组分析适当方法的使用和报告。提供了改进分析方法的建议。

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