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Insufficient information size and potentially false results in orthodontic meta-analyses using trial sequential
Samer Mheissen1, Mays Aldandan2, Haris Khan3
1Syrian Board in Orthodontics, Private Practice, Damascus, Syria.
European Journal of Orthodontics
|August 14, 2023
Summary
Trial sequential analysis (TSA) revealed that many orthodontic meta-analyses (MAs) yield potentially false-positive results due to insufficient information size. This highlights the need for robust evidence evaluation in orthodontic systematic reviews.
Area of Science:
- Orthodontics
- Biostatistics
- Evidence-based dentistry
Background:
- Meta-analysis (MA) is a statistical method for systematic reviews (SRs).
- MA can lead to effect over/underestimation from systematic and random errors.
- Trial sequential analysis (TSA) addresses MA limitations.
Purpose of the Study:
- Re-evaluate orthodontic MAs using TSA.
- Investigate the conclusiveness of MA findings.
- Estimate the required information size (IS) for orthodontic MAs.
Main Methods:
- Selected orthodontic SRs with MAs published 2013-2022.
- Extracted arm-level data from included MAs.
- Re-analyzed data using TSA software.
Main Results:
- 50 SRs with MAs were included in the analysis.
- Nearly half of significant MAs showed firm evidence; 38% showed potentially spurious evidence.
- Insignificant MAs rarely indicated a lack of effect; more patients were needed when evidence was absent.
Conclusions:
- Many orthodontic MAs may have false-positive results.
- Orthodontic MAs often have insufficient information size.
- TSA is crucial for evaluating the reliability of orthodontic MA findings.
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