Unit of Cancer Epidemiology, Scientific Institute of Public Health, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
Center for Statistics, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium.
Arch Public Health. 2014 Nov 10;72(1):39. doi: 10.1186/2049-3258-72-39. eCollection 2014.
BACKGROUND: Meta-analyses have become an essential tool in synthesizing evidence on clinical and epidemiological questions derived from a multitude of similar studies assessing the particular issue. Appropriate and accessible statistical software is needed to produce the summary statistic of interest. METHODS: Metaprop is a statistical program implemented to perform meta-analyses of proportions in Stata. It builds further on the existing Stata procedure metan which is typically used to pool effects (risk ratios, odds ratios, differences of risks or means) but which is also used to pool proportions. Metaprop implements procedures which are specific to binomial data and allows computation of exact binomial and score test-based confidence intervals. It provides appropriate methods for dealing with proportions close to or at the margins where the normal approximation procedures often break down, by use of the binomial distribution to model the within-study variability or by allowing Freeman-Tukey double arcsine transformation to stabilize the variances. Metaprop was applied on two published meta-analyses: 1) prevalence of HPV-infection in women with a Pap smear showing ASC-US; 2) cure rate after treatment for cervical precancer using cold coagulation. RESULTS: The first meta-analysis showed a pooled HPV-prevalence of 43% (95% CI: 38%-48%). In the second meta-analysis, the pooled percentage of cured women was 94% (95% CI: 86%-97%). CONCLUSION: By using metaprop, no studies with 0% or 100% proportions were excluded from the meta-analysis. Furthermore, study specific and pooled confidence intervals always were within admissible values, contrary to the original publication, where metan was used.
背景:荟萃分析已成为综合来自大量类似研究的临床和流行病学问题证据的重要工具,这些研究评估了特定问题。需要适当和易于访问的统计软件来生成感兴趣的汇总统计信息。
方法:Metaprop 是一个在 Stata 中执行比例荟萃分析的统计程序。它进一步建立在现有的 Stata 程序 metan 之上,该程序通常用于汇总效应(风险比、优势比、风险或均值差异),但也用于汇总比例。Metaprop 实现了专门针对二项数据的程序,并允许计算精确的二项式和基于得分检验的置信区间。它提供了适当的方法来处理接近或处于边缘的比例,在这些比例下,正态逼近程序通常会失效,通过使用二项式分布来模拟研究内的变异性,或者允许 Freeman-Tukey 双反正弦变换来稳定方差。Metaprop 应用于两个已发表的荟萃分析:1)巴氏涂片显示 ASC-US 的女性中 HPV 感染的流行率;2)使用冷凝治疗宫颈癌前病变的治愈率。
结果:第一项荟萃分析显示 HPV 总流行率为 43%(95%CI:38%-48%)。在第二项荟萃分析中,治愈女性的总比例为 94%(95%CI:86%-97%)。
结论:通过使用 Metaprop,没有将 0%或 100%比例的研究排除在荟萃分析之外。此外,与原始出版物中使用 metan 相反,研究特定和汇总置信区间始终在可接受的范围内。
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