Imputing variance estimates do not alter the conclusions of a meta-analysis with continuous outcomes: a case study of changes in renal function after living kidney donation

Thiessen-Philbrook, Heather; Barrowman, Nicholas; Garg, Amit X.

doi:10.1016/j.jclinepi.2006.06.018

Cited by 77 publications

(31 citation statements)

References 42 publications

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“…This did not change our overall conclusion as the pooled estimates and confidence intervals were not significantly changed in terms of magnitude or directionality (data not shown). Although a certain degree of uncertainty exists regarding the accuracy of the results derived from this approach, there is a growing body of the literature indicating the validity of results from meta-analyses utilizing various imputation methods [29, 30]. …”

Section: Discussionmentioning

confidence: 99%

Effect of Domperidone on Insufficient Lactation in Puerperal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Osadchy

Moretti

Koren

2012

Obstetrics and Gynecology International

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Background. There is a controversy within the medical community regarding the role of domperidone as a galactagogue and the drug has been removed from the US market owing to safety concerns. Objective. To perform a systematic review and meta-analysis of the available data assessing the effect of domperidone on breast milk production in women experiencing insufficient lactation. Study Selection. Randomized controlled trials (RCTs) examining the effect of domperidone on breast milk production of puerperal women were eligible for inclusion. Data Analysis. Absolute and relative changes from baseline were calculated for individual studies and pooled using a random effects model. Results. Three RCTs including 78 participants met the inclusion criteria. All showed a statistically significant increase in breast milk production following treatment with domperidone. The analysis of pooled data demonstrated a statistically significant relative increase of 74.72% (95% CI = 54.57; 94.86, P < 0.00001) in daily milk production with domperidone treatment compared to placebo. No maternal or neonatal adverse events were observed in any of the trials. Conclusions. Evidence from a few small RCTs of moderate to high quality suggests that domperidone produces a greater increase in breast milk supply than placebo.

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Section: Discussionmentioning

confidence: 99%

Effect of Domperidone on Insufficient Lactation in Puerperal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Osadchy

Moretti

Koren

2012

Obstetrics and Gynecology International

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“…One trial reported SD c s for its drug and placebo groups that were less than 25% the size of the other trials; because preliminary analyses also revealed that this trial was an outlier, these two standard deviations were treated as missing and imputed. In total, SD c s were known for 28 groups, could be calculated from other inferential statistics in nine comparisons (18 groups), and were imputed in 12 comparisons (24 groups) (47.38%) [13,14]. …”

Section: Methodsmentioning

confidence: 99%

Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration

et al. 2008

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BackgroundMeta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included, the benefit falls below accepted criteria for clinical significance. Yet, the efficacy of the antidepressants may also depend on the severity of initial depression scores. The purpose of this analysis is to establish the relation of baseline severity and antidepressant efficacy using a relevant dataset of published and unpublished clinical trials.Methods and FindingsWe obtained data on all clinical trials submitted to the US Food and Drug Administration (FDA) for the licensing of the four new-generation antidepressants for which full datasets were available. We then used meta-analytic techniques to assess linear and quadratic effects of initial severity on improvement scores for drug and placebo groups and on drug–placebo difference scores. Drug–placebo differences increased as a function of initial severity, rising from virtually no difference at moderate levels of initial depression to a relatively small difference for patients with very severe depression, reaching conventional criteria for clinical significance only for patients at the upper end of the very severely depressed category. Meta-regression analyses indicated that the relation of baseline severity and improvement was curvilinear in drug groups and showed a strong, negative linear component in placebo groups.ConclusionsDrug–placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication.

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“…9 Missing standard deviations for pretreatment and posttreatment mean values were imputed by using the arithmetic mean of available standard deviations. 10 Missing standard deviations for change scores were calculated using pre-intervention and post-intervention means and standard deviations, with a correlation coefficient of 0.5. 11 Due to clinical differences between RCTs (ie medication types, inclusion criteria) we pooled WMDs using DerSimonian and Laird random effects models.…”

Section: Methodsmentioning

confidence: 99%

The Efficacy and Safety of Combined Therapy with α-Blockers and Anticholinergics for Men with Benign Prostatic Hyperplasia: A Meta-Analysis

et al. 2013

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Purpose We performed a meta-analysis to compare treatment with α-blockers and anticholinergics (ie combination therapy) to α-blocker monotherapy to clarify the efficacy and safety of this treatment approach among men with storage urinary symptoms related to benign prostatic hyperplasia. Materials and Methods We searched for trials of men with benign prostatic hyperplasia/lower urinary tract symptoms that were randomized to combination treatment or α-blockers alone. We pooled data from 7 placebo controlled trials meeting inclusion criteria. Primary outcomes of interest included changes in International Prostate Symptom Score (storage subscores) and urinary frequency. We also assessed post-void residual volume, maximal flow rate and the incidence of urinary retention. Data were pooled using random effects models for continuous outcomes and the Peto method to generate odds ratios for acute urinary retention. Results Combination therapy had a significantly greater reduction in International Prostate Symptom Score storage subscores (Δ −0.73, 95% CI −1.09 – −0.37) and voiding frequency (Δ −0.69 voids, 95% CI −0.97 – −0.41). There was also a greater reduction in maximal urinary flow rate (Δ −0.59 ml per second, 95% CI −1.04 – −0.14) and increase in post-void residual urine volume (Δ 11.60 ml, 95% CI 8.50–14.70) with combination therapy. The number needed to treat with combination therapy to cause 1 acute urinary retention episode was 101 (95% CI 60–267). Conclusions Combination treatment with α-blockers and anticholinergics significantly improved storage voiding parameters compared to men treated with α-blocker therapy alone. This treatment approach is safe with a minimal risk of increased post-void residual urine volume, decreased maximal urinary flow rate or acute urinary retention.

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Imputing variance estimates do not alter the conclusions of a meta-analysis with continuous outcomes: a case study of changes in renal function after living kidney donation

Cited by 77 publications

References 42 publications

Effect of Domperidone on Insufficient Lactation in Puerperal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effect of Domperidone on Insufficient Lactation in Puerperal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration

The Efficacy and Safety of Combined Therapy with α-Blockers and Anticholinergics for Men with Benign Prostatic Hyperplasia: A Meta-Analysis

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