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Assessing the robustness of direct meta-analysis in the presence of heterogeneity

Claire Ainsworth1

  • 1RTI Health Solutions, Manchester, UK.

Journal of Comparative Effectiveness Research
|August 23, 2018
PubMed
Abstract

Insights

This study confirmed findings from systematic reviews on atypical antipsychotics for schizophrenia. Confirmatory sensitivity analysis validated results, showing minimal differences in efficacy measures.

Area of Science:

  • Psychiatry
  • Pharmacology
  • Biostatistics

Background:

  • Systematic reviews on atypical antipsychotics for schizophrenia are common.
  • Heterogeneity can impact the robustness of findings in these reviews.

Purpose of the Study:

  • To assess the robustness of findings in recent systematic reviews of atypical antipsychotics in schizophrenia patients.
  • To evaluate the impact of heterogeneity on review outcomes.

Main Methods:

  • Relative efficacy was measured using mean difference (MD) in Positive and Negative Syndrome Scale (PANSS) total scores across seven direct comparisons.
  • Meta-analysis results were compared using four alternate strategies, analyzing the difference in MD (ΔMD).

Main Results:

  • Mean differences in PANSS total scores were smaller in conventional meta-analyses compared to three of four alternative strategies, with small differences (ΔMD <4).
  • Limit meta-analysis comparisons showed no considerable differences in effect size (|ΔMD| <1).

Conclusions:

  • The conducted analyses validated the results of the systematic reviews.
  • Confirmatory sensitivity analysis proved valuable in demonstrating the robustness of the findings.
Keywords:
antipsychotic agentsheterogeneitymeta-analysispublication biasschizophreniasmall study effects

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