Department of Statistics, Florida State University, Tallahassee, Florida, USA.
Department of Biostatistics, University of Florida, Gainesville, Florida, USA.
Stat Med. 2022 Feb 10;41(3):500-516. doi: 10.1002/sim.9261. Epub 2021 Nov 18.
Systematic reviews and meta-analyses are principal tools to synthesize evidence from multiple independent sources in many research fields. The assessment of heterogeneity among collected studies is a critical step when performing a meta-analysis, given its influence on model selection and conclusions about treatment effects. A common-effect (CE) model is conventionally used when the studies are deemed homogeneous, while a random-effects (RE) model is used for heterogeneous studies. However, both models have limitations. For example, the CE model produces excessively conservative confidence intervals with low coverage probabilities when the collected studies have heterogeneous treatment effects. The RE model, on the other hand, assigns higher weights to small studies compared to the CE model. In the presence of small-study effects or publication bias, the over-weighted small studies from a RE model can lead to substantially biased overall treatment effect estimates. In addition, outlying studies may exaggerate between-study heterogeneity. This article introduces penalization methods as a compromise between the CE and RE models. The proposed methods are motivated by the penalized likelihood approach, which is widely used in the current literature to control model complexity and reduce variances of parameter estimates. We compare the existing and proposed methods with simulated data and several case studies to illustrate the benefits of the penalization methods.
系统评价和荟萃分析是综合来自多个独立来源的证据的主要工具,在许多研究领域都有应用。当进行荟萃分析时,评估收集研究之间的异质性是一个关键步骤,因为它会影响模型选择和对治疗效果的结论。当研究被认为是同质的时,通常使用固定效应(CE)模型,而当研究是异质的时,则使用随机效应(RE)模型。然而,这两种模型都存在局限性。例如,当收集的研究具有异质的治疗效果时,CE 模型会产生过度保守的置信区间,置信区间的覆盖率很低。另一方面,RE 模型相对于 CE 模型会给小研究分配更高的权重。在存在小研究效应或发表偏倚的情况下,RE 模型中加权过高的小研究可能会导致整体治疗效果估计产生严重的偏差。此外,异常研究可能会夸大研究间的异质性。本文介绍了惩罚方法,作为 CE 和 RE 模型之间的折衷。所提出的方法受到惩罚似然方法的启发,该方法在当前文献中被广泛用于控制模型复杂性和减少参数估计的方差。我们使用模拟数据和几个案例研究来比较现有和提出的方法,以说明惩罚方法的好处。