<div dir="ltr"><div dir="ltr"><font face="arial, sans-serif"><br></font><div><font face="arial, sans-serif">Dear All!</font></div><div>Thanks a lot everyone for helping me to conduct the meta analyses and making me reach to results stage of the manuscript.</div><div><br></div><div><font face="arial, sans-serif">However, I still have some crucial questions regarding interpretation of meta-analysis with HR values, alongwith meta-analysis of their respective P-values.</font></div><div><font face="arial, sans-serif" size="4"><b><br></b></font></div><div><font face="arial, sans-serif"><br></font></div><div><font size="4" face="arial, sans-serif"><b>Data Collection:</b></font></div><div><font size="4" face="arial, sans-serif"><b><br></b></font></div><div><font face="arial, sans-serif">Mainly, I have gathered <b style="">2-4 P values each of Hazard Ratios (HR values given with CIs) from studies on</b> <b style="">specific</b> <b style="">prognostic markers reporting</b> <b style="">DFS, OS and DSS</b>. </font></div><div><font face="arial, sans-serif"><br></font></div><div><font face="arial, sans-serif"><br></font></div><div><b><font size="4" face="arial, sans-serif"><u>R Studio Codes for meta-analysis of HR values:</u></font></b><font face="arial, sans-serif"><br></font></div><div><b><font size="4" face="arial, sans-serif"><br></font></b></div><div><b>library(meta)</b></div><div>  <b><br>settings.meta(digits = 2, layout = "RevMan5") <br></b></div><div><b><br></b></div><div><b>HR <- c(1.34,1.95)                                                                                     </b><i> (Hypothetical values)</i></div><div><b>  <br>lower.HR <- c(1.10,0.75)        </b></div><div><b><br>upper.HR <- c(2.34,2.25)       </b></div><div><b>     <br>study<- c("ABC et al. 2018","EFG et al. 2020")</b></div><div><b><br>m2<-metagen(log(HR),lower=log(lower.HR),upper=log(upper.HR),studlab=study,sm="HR")</b></div><div><b><br>m2</b></div><div><b><br>forest(m2)</b></div><div><b>  <br>grid::grid.text("Meta-analysis of Prognostic marker for Multivariate DFS", <br>                0.5, 0.94, gp = grid::gpar(cex = 1.5)) </b><br></div><div><br></div><div><font face="arial, sans-serif"><br></font></div><div><b><font size="4" face="arial, sans-serif"><u>R Studio Codes for meta-analysis of P values:</u></font></b></div><div><b><font size="4" face="arial, sans-serif"><br></font></b></div><div><pre style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-origin:initial;background-clip:initial;word-break:break-all;margin:0in 0in 0.0001pt;font-size:10pt"><b><span style="color:black;border:1pt none windowtext;padding:0in"><font face="arial, sans-serif">install.packages("BiocManager")</font></span></b></pre><pre style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-origin:initial;background-clip:initial;word-break:break-all;margin:0in 0in 0.0001pt;font-size:10pt"><span style="color:black;border:1pt none windowtext;padding:0in"><font face="arial, sans-serif"> </font></span></pre><pre style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-origin:initial;background-clip:initial;word-break:break-all;margin:0in 0in 0.0001pt;font-size:10pt"><b><span style="color:black;border:1pt none windowtext;padding:0in"><font face="arial, sans-serif">BiocManager::install("multtest")</font></span></b></pre><pre style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-origin:initial;background-clip:initial;word-break:break-all;margin:0in 0in 0.0001pt;font-size:10pt"><span style="color:black;border:1pt none windowtext;padding:0in"><font face="arial, sans-serif"> </font></span></pre><pre style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-origin:initial;background-clip:initial;word-break:break-all;margin:0in 0in 0.0001pt;font-size:10pt"><b><span style="color:black;border:1pt none windowtext;padding:0in"><font face="arial, sans-serif">install.packages("metap")</font></span></b></pre><pre style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-origin:initial;background-clip:initial;word-break:break-all;margin:0in 0in 0.0001pt;font-size:10pt"><b><span style="color:black;border:1pt none windowtext;padding:0in"><font face="arial, sans-serif"> </font></span></b></pre><pre style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-origin:initial;background-clip:initial;word-break:break-all;margin:0in 0in 0.0001pt;font-size:10pt"><b><span style="color:black;border:1pt none windowtext;padding:0in"><font face="arial, sans-serif">library(metap)</font></span></b></pre><pre style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-origin:initial;background-clip:initial;word-break:break-all;margin:0in 0in 0.0001pt;font-size:10pt"><span style="color:black;border:1pt none windowtext;padding:0in"><font face="arial, sans-serif"> </font></span></pre><pre style="background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-origin:initial;background-clip:initial;word-break:break-all;margin:0in 0in 0.0001pt"><span style="color:black;border:1pt none windowtext;padding:0in"><font face="arial, sans-serif"><pre style="font-size:10pt;background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-origin:initial;background-clip:initial;word-break:break-all;margin:0in 0in 0.0001pt"><span style="border:1pt none windowtext;padding:0in"><b>pvals <- c(0.08,0.3)            </b><i>(Hypothetical values)</i></span></pre><pre style="font-size:10pt;background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-origin:initial;background-clip:initial;word-break:break-all;margin:0in 0in 0.0001pt"><span style="border:1pt none windowtext;padding:0in"><b><i> </i></b></span></pre><pre style="font-size:10pt;background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-origin:initial;background-clip:initial;word-break:break-all;margin:0in 0in 0.0001pt"><span style="border:1pt none windowtext;padding:0in"><b>result <- sumlog(pvals)</b></span></pre><pre style="font-size:10pt;background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-origin:initial;background-clip:initial;word-break:break-all;margin:0in 0in 0.0001pt"><span style="border:1pt none windowtext;padding:0in"><b> </b></span></pre><pre style="font-size:10pt;background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-origin:initial;background-clip:initial;word-break:break-all;margin:0in 0in 0.0001pt"><span style="border:1pt none windowtext;padding:0in"><b>result</b></span></pre><pre style="font-size:10pt;background-image:initial;background-position:initial;background-size:initial;background-repeat:initial;background-origin:initial;background-clip:initial;word-break:break-all;margin:0in 0in 0.0001pt"><span style="border:1pt none windowtext;padding:0in"><b><br></b></span></pre><span style="font-size:10pt">
</span></font></span></pre></div><div><b><font size="4" face="arial, sans-serif"><u>Results of Meta-analysis with P values:</u></font></b></div><div><b><font size="4" face="arial, sans-serif"><br></font></b></div><div><p class="MsoNormal" style="margin:0in 0in 8pt;line-height:107%;font-size:11pt"><span style="font-size:12pt;line-height:107%"><font face="arial, sans-serif">1. chisq = 
16.66974  with df =  4  p
=  0.002240369</font></span></p><p class="MsoNormal" style="margin:0in 0in 8pt;line-height:107%;font-size:11pt"><span style="font-size:12pt;line-height:107%"><font face="arial, sans-serif"><br></font></span></p></div><div><p class="MsoNormal" style="margin:0in 0in 8pt;line-height:107%;font-size:11pt"><span style="font-size:12pt;line-height:107%"><font face="arial, sans-serif">2. chisq =  35.80921 
with df =  8  p = 
1.902998e-05   (<b></b></font></span><span style="font-family:arial,sans-serif;font-size:small">Do we report this result as 0.000019 in the manuscript ?)</span></p><p class="MsoNormal" style="margin:0in 0in 8pt;line-height:107%;font-size:11pt"><br></p><p class="MsoNormal" style="margin:0in 0in 8pt;line-height:107%;font-size:11pt"><font face="arial, sans-serif"><br></font></p><p class="MsoNormal" style="margin:0in 0in 8pt;line-height:107%;font-size:11pt"><span style="font-size:small"><font size="4" face="arial, sans-serif" style=""><b><u>Questions:</u></b></font></span></p><p class="MsoNormal" style="margin:0in 0in 8pt;line-height:107%;font-size:11pt"><span style="font-size:small"><font size="4" face="arial, sans-serif" style=""><b><br></b></font></span></p><p class="MsoNormal" style="margin:0in 0in 8pt;line-height:107%"><font face="arial, sans-serif" style="">1.Please view attached first image of forest plot which I have got from "Meta" Package in RStudio. The P value in this forest plot is for heterogeneity, but the P value for overall effect size is not there as presented in the second attached image as: <b>(Test or overall effect z=0.35, <i>p</i>=0.7)</b>. Should I, and if "yes" then how to report this P value in my forest plot ?</font></p><p class="MsoNormal" style="margin:0in 0in 8pt;line-height:107%"><font face="arial, sans-serif" style="">And is this P value similar to the P value which I am getting from meta-analysis of P values with "metap" package ? which P value to be reported ideally and usually ?</font></p><p class="MsoNormal" style="margin:0in 0in 8pt;line-height:107%"><font face="arial, sans-serif" style=""><br></font></p><p class="MsoNormal" style="margin:0in 0in 8pt;line-height:107%"><font face="arial, sans-serif">2. Regarding <b>"metap</b>" package my cumulative P values are too low, so how to interpret these results. Is there no image OR forest plot for them to report ? Does the significance level (0.005) changes for cumulative P values ?</font></p><p class="MsoNormal" style="margin:0in 0in 8pt;line-height:107%"><font face="arial, sans-serif"><br></font></p><p class="MsoNormal" style="margin:0in 0in 8pt;line-height:107%"><font face="arial, sans-serif">3. Can I report these cumulative P value meta-analysis results along with regular meta-analysis of cumulative HR values (forest plots) ?</font></p><p class="MsoNormal" style="margin:0in 0in 8pt;line-height:107%"><br></p></div><div><font face="arial, sans-serif">I will be much grateful for your much valuable expert advice to finalize my results.</font></div><div><font face="arial, sans-serif">best regards,</font></div><div><font face="arial, sans-serif">Imran</font></div></div></div>