[R-meta] I have any problems with meta-analysis of proportions

Tue Apr 6 14:48:23 CEST 2021

If you're only taking single arms from the RCTs, then they are essentially observational studies. So yes. Although note that RCT populations tend to be quite highly selected, so may be quite different to those in the observational studies. The key question is whether the populations are similar enough and representative of the population you are interested in.

Nicky

From: Martin Lobo <mlobo4370 using hotmail.com>
Sent: 06 April 2021 13:45
To: r-sig-meta-analysis using r-project.org; Nicky Welton <Nicky.Welton using bristol.ac.uk>
Subject: Re: I have any problems with meta-analysis of proportions

Thank's Nicky.
Regardless of what you mention, could I do the analysis of observational studies and rct together, in this particular case?
Regards
Lorenzo Mart�n Lobo MTSAC, FACC, FESC
Especialista Jerarquizado en Cardiolog�a
Jefe de Dpto Enf. Cardiovasculares y Cardiometabolismo Hospital Militar Campo de Mayo.
Jefe de Cardiolog�a Hospital Militar Campo de Mayo
Ex Jefe de Unidad Coronaria Hospital Militar Campo de Mayo
Miembro Titular de la Sociedad Argentina de Cardiolog�a
Fellow American College of Cardiology
Fellow European Society of Cardiology
Ex Miembro del Area de Investigaci�n de la SAC
Ex Director del Consejo de Aterosclerosis y Trombosis de la SAC
Miembro Asesor del Consejo de Aterosclerosis y Trombosis de la SAC
Ex Director del Consejo de Epidemiolog�a y Prevenci�n Cardiovascular de la SAC
Miembro Asesor del Consejo de Epidemiolog�a y Prevenci�n Cardiovascular de la SAC
Experto en Lipidos de la Sociedad Argentina de Lipidos.
Miembro de la Sociedad Argentina de Lipidos.
Instructor de ACLS de la American Heart Association

________________________________
From: Nicky Welton <Nicky.Welton using bristol.ac.uk<mailto:Nicky.Welton using bristol.ac.uk>>
Sent: Tuesday, April 6, 2021 6:33:55 AM
To: Martin Lobo <mlobo4370 using hotmail.com<mailto:mlobo4370 using hotmail.com>>; r-sig-meta-analysis using r-project.org<mailto:r-sig-meta-analysis using r-project.org> <r-sig-meta-analysis using r-project.org<mailto:r-sig-meta-analysis using r-project.org>>
Subject: RE: I have any problems with meta-analysis of proportions

Dear Martin,

The heterogeneity you are seeing illustrates the fact that whilst relative effects from RCTs may be reasonably generalisable across studies / populations, the absolute proportion on a given arm typically is not and can exhibit (extremely) high levels of heterogeneity (regardless of how good quality the studies are). I'd advise you to think very carefully about the population for which you want the pooled estimate to generalise to, and define your inclusion / exclusion criteria pretty narrowly to match that.

Best wishes,

Nicky

-----Original Message-----
From: R-sig-meta-analysis <r-sig-meta-analysis-bounces using r-project.org<mailto:r-sig-meta-analysis-bounces using r-project.org>> On Behalf Of Martin Lobo
Sent: 05 April 2021 17:32
To: r-sig-meta-analysis using r-project.org<mailto:r-sig-meta-analysis using r-project.org>
Subject: [R-meta] I have any problems with meta-analysis of proportions

Hi everyone,

I performed  a systematic review on the persistence of some drugs.
I found 30 randomized clinical trials and 10 observational studies.
Although I understand that they should not be meta analyzed together (I should stratify them or analyze them separately), Actually, of the RCTs, I only use the active drug arm, so I think that by breaking the branching, maybe I could take all the data as observational.
Is this correct ?
If so, how do I describe the methodological part, what guidelines and quality scales should I use (PRISMA, STROBE, COCHRANE, NOS, JADAD?).

On the other hand, I have never performed meta-analysis of proportions, and I am having too much heterogeneity I2 97%. How could I control this? The studies are of good quality. I use the metaprop function.

Than's

Lorenzo Mart n Lobo MTSAC, FACC, FESC
Especialista Jerarquizado en Cardiolog a Jefe de Dpto Enf. Cardiovasculares y Cardiometabolismo Hospital Militar Campo de Mayo.
Jefe de Cardiolog a Hospital Militar Campo de Mayo Ex Jefe de Unidad Coronaria Hospital Militar Campo de Mayo Miembro Titular de la Sociedad Argentina de Cardiolog a Fellow American College of Cardiology Fellow European Society of Cardiology Ex Miembro del Area de Investigaci n de la SAC Ex Director del Consejo de Aterosclerosis y Trombosis de la SAC Miembro Asesor del Consejo de Aterosclerosis y Trombosis de la SAC Ex Director del Consejo de Epidemiolog a y Prevenci n Cardiovascular de la SAC

Miembro Asesor del Consejo de Epidemiolog a y Prevenci n Cardiovascular de la SAC

Experto en Lipidos de la Sociedad Argentina de Lipidos.
Miembro de la Sociedad Argentina de Lipidos.
Instructor de ACLS de la American Heart Association

________________________________
De: R-sig-meta-analysis <r-sig-meta-analysis-bounces using r-project.org<mailto:r-sig-meta-analysis-bounces using r-project.org>> en nombre de r-sig-meta-analysis-request using r-project.org<mailto:r-sig-meta-analysis-request using r-project.org> <r-sig-meta-analysis-request using r-project.org<mailto:r-sig-meta-analysis-request using r-project.org>>
Enviado: s bado, 31 de octubre de 2020 08:05
Para: r-sig-meta-analysis using r-project.org<mailto:r-sig-meta-analysis using r-project.org> <r-sig-meta-analysis using r-project.org<mailto:r-sig-meta-analysis using r-project.org>>
Asunto: R-sig-meta-analysis Digest, Vol 41, Issue 19

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Today's Topics:

   1. Re: GOSH plots for multi-level meta (rma.mv) (Hellen Mirr)

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Message: 1
Date: Fri, 30 Oct 2020 13:03:34 +0000
From: Hellen Mirr <hellenmir554 using gmail.com<mailto:hellenmir554 using gmail.com>>
To: "Viechtbauer, Wolfgang (SP)"
        <wolfgang.viechtbauer using maastrichtuniversity.nl<mailto:wolfgang.viechtbauer using maastrichtuniversity.nl>>
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Subject: Re: [R-meta] GOSH plots for multi-level meta (rma.mv)
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Dear Wolfgang,

Thank you very much for your clear explanation.

Best,
Hellen

On Fri, Oct 30, 2020 at 11:48 AM Viechtbauer, Wolfgang (SP) < wolfgang.viechtbauer using maastrichtuniversity.nl<mailto:wolfgang.viechtbauer using maastrichtuniversity.nl>> wrote:

> Dear Hellen,
>
> This is currently not implemented in metafor. In principle, the idea
> of a GOSH plot does generalize to more complex models although one
> needs to think about whether one would want to create subsets based on
> the indiviual estimates or based on some higher-level grouping
> variable. For example, suppose we have a multilevel structure such as:
>
> study  esid  yi vi
> ------------------
> 1      1     .  .
> 1      2     .  .
> 2      1     .  .
> 3      1     .  .
> 3      2     .  .
> 3      3     .  .
> 4      1     .  .
>
> So, what are, for example, then the subsets of size 2? Are they based
> just on the rows? Then the estimates in row 1 and 2 would be one such
> subset. Or does one base the subsets on the studies? Then rows 1, 2, 3
> (i.e., studies
> 1 and 2) would be such a subset.
>
> This could all be implemented (just like cooks.distance() and
> rstudent() allow for the optional specification of a clustering
> variable), but I haven't done this.
>
> Aside from that: Fitting rma.mv models can take a bit of time. Doing
> this 1000's of times (based on all possible subsets) could take a LONG time.
>
> Best,
> Wolfgang
>
> >-----Original Message-----
> >From: R-sig-meta-analysis [mailto:
> r-sig-meta-analysis-bounces using r-project.org<mailto:r-sig-meta-analysis-bounces using r-project.org>]
> >On Behalf Of Hellen Mirr
> >Sent: Friday, 30 October, 2020 12:12
> >To: r-sig-meta-analysis using r-project.org<mailto:r-sig-meta-analysis using r-project.org>
> >Subject: [R-meta] GOSH plots for multi-level meta (rma.mv)
> >
> >Hello,
> >
> >Apologies if this has already been answered, as I could not find any
> >threads on it.
> >I was wondering whether it is possible to create a GOSH plot for a
> >multi-level meta analysis that is an rma.mv object, and how I would
> >go about that.
> >
[[elided Hotmail spam]]
> >
> >Best wishes
> >Hellen
>

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