Meister Ramona, von Wolff Alessa, Kriston Levente
Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg 20246, Germany.
Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg 20246, Germany.
J Clin Epidemiol. 2015 Jul;68(7):740-51. doi: 10.1016/j.jclinepi.2015.02.006. Epub 2015 Feb 18.
To empirically evaluate the performance of methods for estimating odds ratios and their corresponding standard errors from continuous end point data for meta-analysis.
A database of randomized controlled trials of chronic depression treatments was used. Trials that reported both continuous and dichotomous end points for symptom improvement were considered. Odds ratios and standard errors were calculated from the dichotomous data and estimated from the continuous data using currently available methods: Hasselblad and Hedges (HH), Cox and Snell (CS), Furukawa (F), Suissa (S), and Kraemer and Kupfer (KK). Single and meta-analytically pooled observed and estimated values were compared.
A total of 26 trials were included. At the trial level, four of five (HH, CS, F, and S) and three of four (HH, F, and S) methods for estimating odds ratios and standard errors performed well, respectively. We found considerable differences in the performance of all methods across trials with more accurate estimates for smaller treatment effects. At the level of meta-analysis, three of four methods (CS, F, and S) performed acceptably.
Odds ratios and standard errors can be approximated from continuous end points, but we recommend sensitivity and subgroup analyses to test robustness of the findings.
通过实证评估从连续终点数据估计比值比及其相应标准误的方法在荟萃分析中的性能。
使用了一个慢性抑郁症治疗的随机对照试验数据库。纳入那些报告了症状改善的连续和二分终点的试验。比值比和标准误根据二分数据计算得出，并使用现有方法从连续数据中估计得出：哈塞尔布拉德和赫奇斯法（HH）、考克斯和斯内尔法（CS）、古川法（F）、苏伊萨法（S）以及克雷默和库普弗法（KK）。比较了单个试验以及荟萃分析汇总后的观察值和估计值。
共纳入26项试验。在单个试验层面，估计比值比和标准误的五种方法中的四种（HH、CS、F和S）以及四种方法中的三种（HH、F和S）分别表现良好。我们发现所有方法在不同试验中的性能存在显著差异，对于较小的治疗效果估计更为准确。在荟萃分析层面，四种方法中的三种（CS、F和S）表现尚可。
比值比和标准误可以从连续终点近似得出，但我们建议进行敏感性分析和亚组分析以检验研究结果的稳健性。
