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

Michael Dewey ||@t@ @end|ng |rom dewey@myzen@co@uk
Fri Apr 9 15:07:42 CEST 2021 

Dear Martin

On 08/04/2021 17:15, Martin Lobo wrote:
> thank you all, you have clarified a lot for me.
> some clarifications for you
> 
> *Michael,*
>   In this quiestion:
> If so, how do I describe the methodological part, what guidelines and 
> quality scales should I use (PRISMA, STROBE, COCHRANE, NOS, JADAD?).
> 
> I have read that for meta analysis of observational studies the STROBE 
> guide should be used. Is it the same to use the PRISMA gui as the STROBE 
> in this type of meta analysis?
> 

That seems to me wrong. It is a meta-analysis so it needs to be reported 
and assessed as a meta-analysis. What you would use for the primary 
studies is irrelevant. After all for a meta-analysis of randomised 
trials you would use PRISMA and CONSORT.

As far as heterogeneity is concerned I would not be bothered about it. 
In a m-a of observational studies it is to be expected. After all, 
suppose you did a study on a condition with a global impact. Would you 
expect to see the same results in Algeria, Angola, Argentina, Australia, 
Austria, ...? One thing I would suggest, following on from an insightful 
comment by Nicky in an earlier part of the thread is that you include a 
moderator with two levels: study was a trial, study was a cohort. This 
would help to account for the probably differences in case-mix between 
the two sorts of study. I would also suggest that you incorporate 
prediction intervals as these may be more be beneficial in generalising 
your results.

For some helpful comments about heterogeneity see

@article{rucker08b,
    author = {R\"ucker, G and Schwarzer, G and Carpenter, J R and
       Schumacher, M},
    title = {Undue reliance on {$I^2$} in assessing heterogeneity
       may mislead},
    journal = {BMC Medical Research Methodology},
    year = {2008},
    volume = {8},
    number = {79},
    keywords = {meta-analysis, heterogeneity}
}


For prediction intervals see

@article{riley11,
    author = {Riley, R D and Higgins, J P T and Deeks, J J},
    title = {Interpretation of random effects meta--analyses},
    journal = {British Medical Journal},
    year = {2011},
    volume = {342},
    pages = {964--967},
    keywords = {meta-analysis, random effects}
}


> 
> *Lukasz,*
> *
> *
> In some of my examples the I2 is 97%, T2 (square tau)0.06 (0 <0.01), in 
> this case how would you consider heterogenicity?
> the proportion estimates vary from 0.28 to 0.59.
> 
> Thank's for your help
> 
> Regards
> 
> 
> 
> */
> /*
> */Lorenzo Martín Lobo /**/^MTSAC, FACC, FESC /*
> /*Especialista Jerarquizado en Cardiología*/
> /*/*Jefe de Dpto Enf. Cardiovasculares y Cardiometabolismo Hospital 
> Militar Campo de Mayo.*/
> */
> /*/*Jefe de Cardiología *//*Hospital Militar Campo de Mayo*/
> */
> /*Ex Jefe de Unidad Coronaria *//*Hospital Militar Campo de Mayo*/
> /
> /*Miembro Titular de la Sociedad Argentina de Cardiología*/
> /
> /
> /*Fellow American College of Cardiology*/
> /
> /
> /*Fellow European Society of Cardiology*/
> /
> /
> /*/*Ex Miembro del Area de Investigación 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 Epidemiología y Prevención Cardiovascular 
> de la SAC*/
> /*/
> /*/
> /*/
> /*//*/
> /*/
> /*Miembro Asesor del Consejo de Epidemiología y Prevención 
> 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:* Michael Dewey <lists using dewey.myzen.co.uk>
> *Enviado:* martes, 6 de abril de 2021 05:48
> *Para:* Martin Lobo <mlobo4370 using hotmail.com>; 
> r-sig-meta-analysis using r-project.org <r-sig-meta-analysis using r-project.org>
> *Asunto:* Re: [R-meta] I have any problems with meta-analysis of 
> proportions
> Comments in-line
> 
> On 05/04/2021 17:32, Martin Lobo wrote:
>> 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.
> 
> Yes, you now have a set of observational studies if you only take one
> arm from the trials.
> 
>> 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?).
>>
> 
> It is still a meta-analysis so use PRISMA
> 
>> 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.
>> 
> 
> In a meta-analysis of observational studies high heterogeneity is almost
> ineitable.
> 
>> 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> en nombre de r-sig-meta-analysis-request using r-project.org <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 <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:
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>>     1. Re: GOSH plots for multi-level meta (rma.mv) (Hellen Mirr)
>> 
>> ----------------------------------------------------------------------
>> 
>> Message: 1
>> Date: Fri, 30 Oct 2020 13:03:34 +0000
>> From: Hellen Mirr <hellenmir554 using gmail.com>
>> To: "Viechtbauer, Wolfgang (SP)"
>>          <wolfgang.viechtbauer using maastrichtuniversity.nl>
>> Cc: "r-sig-meta-analysis using r-project.org"
>>          <r-sig-meta-analysis using r-project.org>
>> Subject: Re: [R-meta] GOSH plots for multi-level meta (rma.mv)
>> Message-ID:
>>          <CAF6nRJqkgQ4_vkF0sdf=_anW2Etp2snB14F-v0ot8rZ9JFaXGQ using mail.gmail.com>
>> Content-Type: text/plain; charset="utf-8"
>> 
>> 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> 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]
>>>> On Behalf Of Hellen Mirr
>>>> Sent: Friday, 30 October, 2020 12:12
>>>> To: 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
>>>
>> 
>>          [[alternative HTML version deleted]]
>> 
>> 
>> 
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> Michael
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Michael
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