Faggion Clovis Mariano, Menne Max Clemens, Pandis Nikolaos
Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University Hospital Münster, Münster, Germany.
Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Bern, Switzerland.
Eur J Oral Sci. 2021 Dec;129(6):e12827. doi: 10.1111/eos.12827. Epub 2021 Dec 5.
This focus article aims to highlight the value of reporting prediction intervals (PIs) in random effects meta-analysis and to assess the prevalence of PI-reporting in periodontology and implant dentistry meta-analyses. We searched in the PubMed database for meta-analyses published in the fields of periodontology and implant dentistry. We selected meta-analyses related to primary outcomes with at least three trials. Additionally, we extracted information on the type of the meta-analysis model (fixed or random) and whether the random effects meta-analyses included PIs in addition to the 95% confidence intervals. Three-hundred and forty-nine meta-analyses were found in 94 systematic reviews. Two-hundred and sixty-three (75.4%) subgroup and full meta-analyses used the random-effects model, 81 (23.2%) used fixed-effect methods, and 5 (1.4%) did not specify the model used. In 75 systematic reviews, we found 231 meta-analyses with three or more trials (173 full meta-analyses and 58 subgroup meta-analyses). Only one systematic review reported PIs. Interpretation of the results of random effects meta-analyses which ignore heterogeneity can be misleading. Heterogeneity should be explored, and two common approaches include subgroup analyses and meta-regression. Random effects meta-analyses should include PIs because they convey the extent of heterogeneity in treatment effects across studies in a clinically relevant context.
本焦点文章旨在强调在随机效应荟萃分析中报告预测区间(PI)的价值,并评估牙周病学和种植牙科学荟萃分析中报告PI的普遍性。我们在PubMed数据库中搜索了牙周病学和种植牙科学领域发表的荟萃分析。我们选择了与至少三项试验的主要结局相关的荟萃分析。此外,我们提取了关于荟萃分析模型类型(固定或随机)的信息,以及随机效应荟萃分析除95%置信区间外是否包括PI。在94项系统评价中发现了349项荟萃分析。263项(75.4%)亚组和完整荟萃分析使用随机效应模型,81项(23.2%)使用固定效应方法,5项(1.4%)未指定所使用的模型。在75项系统评价中,我们发现了231项有三项或更多试验的荟萃分析(173项完整荟萃分析和58项亚组荟萃分析)。只有一项系统评价报告了PI。忽略异质性的随机效应荟萃分析结果的解释可能会产生误导。应探索异质性,两种常见方法包括亚组分析和荟萃回归。随机效应荟萃分析应包括PI,因为它们在临床相关背景下传达了各研究间治疗效果异质性的程度。