scholarly journals Strengths and Weaknesses of Meta-Analyses

2018 ◽  
Author(s):  
Katherine S. Corker
Keyword(s):  
Meta Analysis ◽  
History Of ◽  
Meta Analyses

The current chapter briefly reviews the history of meta-analysis before turning to an assessment of its strengths and weaknesses, as well as considerations of alternatives to and modifications of traditional meta-analysis. It closes with recommendations to make meta-analyses more informative.

scholarly journals Lifetime prevalence of non-suicidal self-injury in patients with eating disorders: a systematic review and meta-analysis

2016 ◽  
Vol 46 (7) ◽  
pp. 1345-1358 ◽  
Author(s):  
A. Cucchi ◽  
D. Ryan ◽  
G. Konstantakopoulos ◽  
S. Stroumpa ◽  
A. Ş. Kaçar ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Eating Disorders ◽  
Suicide Attempts ◽  
Meta Analysis ◽  
Weighted Average ◽  
Average Percentage ◽  
Lifetime History ◽  
Self Injury ◽  
History Of ◽  
Meta Analyses

BackgroundAgainst a backdrop of increasing research, clinical and taxonomic attention in non-suicidal self-injury (NSSI), evidence suggests a link between NSSI and eating disorders (ED). The frequency estimates of NSSI in ED vary widely. Little is known about the sources of this variation, and no meta-analysis has quantified the association between ED and NSSI.MethodUsing random-effects meta-analyses, meta-regression analyses, and 1816–6466 unique participants with various ED, we estimated the weighted average percentage of individuals with ED, those with anorexia nervosa (AN) and those with bulimia nervosa (BN) who are reported to have a lifetime history of NSSI across studies. We further examined predictors of NSSI in ED.ResultsThe weighted average percentage of patients with a lifetime history of NSSI was 27.3% [95% confidence interval (CI) 23.8–31.0%] for ED, 21.8% (95% CI 18.5–25.6%) for AN, and 32.7% (95% CI 26.9–39.1%) for BN. The difference between BN and AN was statistically significant [odds ratio (OR) 1.77, 95% CI 1.14–2.77, p = 0.013]. The odds of NSSI increased by 24% for every 10% increase in the percentage of participants with histories of suicide attempts (OR 1.24, 95% CI 1.04–1.48, p = 0.020) and decreased by 26% for every 10% increase in the percentage of participants with histories of substance abuse (OR 0.74, 95% CI 0.58–0.95, p = 0.023).ConclusionsIn the specific context of ED, NSSI is highly prevalent and correlates positively with attempted suicide, urging for NSSI-focused treatments. A novel finding is that NSSI is potentially antagonized by substance abuse.

An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders

2012 ◽  
Vol 43 (6) ◽  
pp. 1133-1149 ◽  
Author(s):  
R. J. Linscott ◽  
J. van Os
Keyword(s):  
Psychotic Disorder ◽  
Meta Analysis ◽  
Psychotic Experiences ◽  
Migrant Status ◽  
Epidemiological Evidence ◽  
Psychosis Proneness ◽  
Temporal Continuity ◽  
History Of ◽  
Meta Analyses ◽  
Fundamental Proposition

BackgroundThe psychosis-proneness–persistence–impairment model of psychotic disorder incorporates notions of both phenomenological and temporal continuity (persistence) of psychotic experiences (PE), but not structural continuity. Specific testable propositions of phenomenological continuity and persistence are identified.MethodPropositions are tested by systematic reviews of the epidemiology of PE, persistence of PE and disorder outcomes, and meta-analyses (including Monte Carlo permutation sampling, MCPS) of reported rates and odds ratios (ORs).ResultsEstimates of the incidence and prevalence of PE obtained from 61 cohorts revealed a median annual incidence of 2.5% and a prevalence of 7.2%. Meta-analysis of risk factors identified age, minority or migrant status, income, education, employment, marital status, alcohol use, cannabis use, stress, urbanicity and family history of mental illness as important predictors of PE. The mode of assessment accounted for significant variance in the observed rates. Across cohorts, the probability of persistence was very strongly related to the rate of PE at baseline. Of those who report PE, ∼20% go on to experience persistent PE whereas for ∼80%, PE remit over time. Of those with baseline PE, 7.4% develop a psychotic disorder outcome.ConclusionsCompelling support is found for the phenomenological and temporal continuity between PE and psychotic disorder and for the fundamental proposition that this relationship is probabilistic. However, imprecision in epidemiological research design, measurement limitations and the epiphenomenological nature of PE invite further robust scrutiny of the continuity theory.

scholarly journals A systematic review and individual patient data meta-analysis of prognostic factors for foot ulceration in people with diabetes: the international research collaboration for the prediction of diabetic foot ulcerations (PODUS)

2015 ◽  
Vol 19 (57) ◽  
pp. 1-210 ◽  
Author(s):  
Fay Crawford ◽  
Genevieve Cezard ◽  
Francesca M Chappell ◽  
Gordon D Murray ◽  
Jacqueline F Price ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Assessment ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Data Sets ◽  
Eligibility Criteria ◽  
Foot Ulceration ◽  
History Of ◽  
Meta Analyses ◽  
Assessment Procedures

BackgroundAnnual foot risk assessment of people with diabetes is recommended in national and international clinical guidelines. At present, these are consensus based and use only a proportion of the available evidence.ObjectivesWe undertook a systematic review of individual patient data (IPD) to identify the most highly prognostic factors for foot ulceration (i.e. symptoms, signs, diagnostic tests) in people with diabetes.Data sourcesStudies were identified from searches of MEDLINE and EMBASE.Review methodsThe electronic search strategies for MEDLINE and EMBASE databases created during an aggregate systematic review of predictive factors for foot ulceration in diabetes were updated and rerun to January 2013. One reviewer applied the IPD review eligibility criteria to the full-text articles of the studies identified in our literature search and also to all studies excluded from our aggregate systematic review to ensure that we did not miss eligible IPD. A second reviewer applied the eligibility criteria to a 10% random sample of the abstract search yield to check that no relevant material was missed. This review includes exposure variables (risk factors) only from individuals who were free of foot ulceration at the time of study entry and who had a diagnosis of diabetes mellitus (either type 1 or type 2). The outcome variable was incident ulceration.ResultsOur search identified 16 cohort studies and we obtained anonymised IPD for 10. These data were collected from more than 16,000 people with diabetes worldwide and reanalysed by us. One data set was kept for independent validation. The data sets contributing IPD covered a range of temporal, geographical and clinical settings. We therefore selected random-effects meta-analysis, which assumes not that all the estimates from each study are estimates of the same underlying true value, but rather that the estimates belong to the same distribution. We selected candidate variables for meta-analysis using specific criteria. After univariate meta-analyses, the most clinically important predictors were identified by an international steering committee for inclusion in the primary, multivariable meta-analysis. Age, sex, duration of diabetes, monofilaments and pulses were considered most prognostically important. Meta-analyses based on data from the entire IPD population found that an inability to feel a 10-g monofilament [odds ratio (OR) 3.184, 95% confidence interval (CI) 2.654 to 3.82], at least one absent pedal pulse (OR 1.968, 95% CI 1.624 to 2.386), a longer duration of a diagnosis of diabetes (OR 1.024, 95% CI 1.011 to 1.036) and a previous history of ulceration (OR 6.589, 95% CI 2.488 to 17.45) were all predictive of risk. Female sex was protective (OR 0.743, 95% CI 0.598 to 0.922).LimitationsIt was not possible to perform a meta-analysis using a one-step approach because we were unable to procure copies of one of the data sets and instead accessed data via Safe Haven.ConclusionsThe findings from this review identify risk assessment procedures that can reliably inform national and international diabetes clinical guideline foot risk assessment procedures. The evidence from a large sample of patients in worldwide settings show that the use of a 10-g monofilament or one absent pedal pulse will identify those at moderate or intermediate risk of foot ulceration, and a history of foot ulcers or lower-extremity amputation is sufficient to identify those at high risk. We propose the development of a clinical prediction rule (CPR) from our existing model using the following predictor variables: insensitivity to a 10-g monofilament, absent pedal pulses and a history of ulceration or lower-extremities amputations. This CPR could replace the many tests, signs and symptoms that patients currently have measured using equipment that is either costly or difficult to use.Study registrationThis study is registered as PROSPERO CRD42011001841.FundingThe National Institute for Health Research Health Technology Assessment programme.

Oral Contraceptives and Risk of Ovarian Cancer and Breast Cancer Among High-Risk Women: A Systematic Review and Meta-Analysis

2013 ◽  
Vol 31 (33) ◽  
pp. 4188-4198 ◽  
Author(s):  
Patricia G. Moorman ◽  
Laura J. Havrilesky ◽  
Jennifer M. Gierisch ◽  
Remy R. Coeytaux ◽  
William J. Lowery ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Family History ◽  
Cancer Risk ◽  
Meta Analysis ◽  
Brca2 Mutation ◽  
Ovarian Cancer Risk ◽  
Mutation Carriers ◽  
History Of ◽  
Meta Analyses

Purpose To estimate the risks of ovarian cancer and breast cancer associated with oral contraceptive (OC) use among women at elevated risk owing to mutations in BRCA1/2 or a strong family history. Methods We searched PubMed, Embase, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov for studies published 2000 to 2012 that evaluated associations between OC use and breast or ovarian cancer among women who are carriers of a BRCA1/2 mutation or have a family history of breast or ovarian cancer. Results From 6,476 unique citations, we identified six studies examining ovarian cancer risk in BRCA1/2 mutation carriers and eight studies examining breast cancer risk in BRCA1/2 mutation carriers. For BRCA1/2 mutation carriers combined, meta-analysis showed an inverse association between OC use and ovarian cancer (odds ratio [OR], 0.58; 95% CI, 0.46 to 0.73) and a nonstatistically significant association with breast cancer (OR, 1.21; 95% CI, 0.93 to 1.58). Findings were similar when examining BRCA1 and BRCA2 mutation carriers separately. Data were inadequate to perform meta-analyses examining duration or timing of use. For women with a family history of ovarian or breast cancer, we identified four studies examining risk for ovarian cancer and three for breast cancer, but differences between studies precluded combining the data for meta-analyses, and no overall pattern could be discerned. Conclusion Our analyses suggest that associations between ever use of OCs and ovarian and breast cancer among women who are BRCA1 or BRCA2 mutation carriers are similar to those reported for the general population.

scholarly journals Assessment of the risks of a myasthenic crisis after thymectomy in patients with myasthenia gravis: a systematic review and meta-analysis of 25 studies

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Chaoying Liu ◽  
Peng Liu ◽  
Xiao jing Zhang ◽  
Wen qian Li ◽  
Guoyan Qi
Keyword(s):  
Risk Factors ◽  
Blood Loss ◽  
Myasthenia Gravis ◽  
Who Classification ◽  
Meta Analysis ◽  
Lung Infection ◽  
Myasthenic Crisis ◽  
Bulbar Symptoms ◽  
History Of ◽  
Meta Analyses

Abstract Background Despite the burgeoning literature describing preoperative and postoperative risks of a myasthenic crisis after thymectomy (MCAT) in patients with myasthenia gravis, substantial differences exist in the risk factors identified by previous studies. We conducted a meta-analysis to assess the reported risk factors and MCAT risk. Methods We collected relevant studies on the risk factors for MCAT by searching the PubMed, Embase, The Cochrane Library, China Biology Medicine (CBM), WanFang Data, VIP and CNKI databases. The search period ranged from the establishment of the database to November 2019. Results Twenty-five of the 458 identified studies were eligible for the meta-analysis. Seven retrospective cohort studies and 18 case-control studies were included, and 14 risk factors for MCAT were extracted. Meta-analyses of the association between MCAT and risk factors related to the patient’s preoperative condition included a preoperative history of MC, preoperative bulbar symptoms, IIa + IIb + III + VI, IIb + III + VI, VI + V, dosage of pyridostigmine bromide prior to the operation, a preoperative AchR-Ab level > 100 (nm/L), preoperative pulmonary function, preoperative complications, and preoperative disease course. Meta-analyses of the association between MCAT and surgery-related risk factors included intraoperative blood loss > 1000 mL and the mode of operation. Meta-analyses of the association between MCAT and postoperative risk factors included postoperative lung infection, thymoma and the WHO classification. The operation time was not an independent risk factor for MCAT. Conclusions The independent risk factors for MCAT were a preoperative history of MC, preoperative bulbar symptoms, preoperative MG Osserman stage, preoperative dosage of pyridostigmine bromide, preoperative serum AchR-Ab level, lung function, major postoperative complications, disease duration before thymectomy, blood loss, thoracotomy, postoperative lung infection, thymoma, and WHO classification.

scholarly journals Epidemiology of psychotic depression – systematic review and meta-analysis

2017 ◽  
Vol 48 (6) ◽  
pp. 905-918 ◽  
Author(s):  
E. Jääskeläinen ◽  
T. Juola ◽  
H. Korpela ◽  
H. Lehtiniemi ◽  
M. Nietola ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Bipolar Disorder ◽  
Meta Analysis ◽  
Psychotic Depression ◽  
Manual Search ◽  
Final Study ◽  
History Of ◽  
Scientific Attention ◽  
Meta Analyses

Large amount of data have been published on non-psychotic depression (NPD), schizophrenia (SZ), and bipolar disorder, while psychotic depression (PD) as an own entity has received much smaller attention. We performed a systematic review and meta-analyses on epidemiology, especially incidence and prevalence, risk factors, and outcomes of PD. A systematic search to identify potentially relevant studies was conducted using four electronic databases and a manual search. The search identified 1764 unique potentially relevant articles, the final study included 99 articles. We found that the lifetime prevalence of PD varies between 0.35% and 1%, with higher rates in older age. Onset age of PD was earlier than that of NPD in younger samples, but later in older samples. There were no differences in gender distribution in PD v. NPD, but higher proportion of females was found in PD than in SZ or in psychotic bipolar disorder (PBD). Risk factors have rarely been studied, the main finding being that family history of psychosis and bipolar disorder increases the risk of PD. Outcomes of PD were mostly worse when compared with NPD, but better compared with SZ and schizoaffective disorder. The outcome compared with PBD was relatively similar, and somewhat varied depending on the measure of the outcome. Based on this review, the amount of research on PD is far from that of NPD, SZ, and bipolar disorder. Based on our findings, PD seems distinguishable from related disorders and needs more scientific attention.

Examining the Associations Between Childhood Trauma, Resilience, and Depression: A Multivariate Meta-Analysis

2021 ◽  
pp. 152483802110293
Author(s):  
Elizabeth R. Watters ◽  
Ariel M. Aloe ◽  
Armeda S. Wojciak
Keyword(s):  
Childhood Trauma ◽  
Meta Analysis ◽  
Sampling Strategy ◽  
Analytical Techniques ◽  
Publication Type ◽  
History Of Childhood ◽  
Individual Outcomes ◽  
History Of ◽  
Meta Analyses ◽  
Trait Resilience

Topic of review: Childhood trauma has been associated with increased depression; however, resilience has been found to reduce this association. Method of review: Present analyses were based on multivariate meta-analytical techniques, an extension of univariate meta-analysis. All computations were performed using the metafor package and the metaRmat package from R. Bivariate associations ( r) between trauma, resilience, and depression were utilized as the pooled effect sizes. Criteria for inclusion: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, articles were coded based on the following inclusion criteria: (a) sample participants had a history of childhood trauma; (b) studies included one of the four instruments of trait resilience; (c) studies included measures of individual outcomes of depression; (d) studies were published in peer-reviewed journals, dissertations, book chapters since 2009, or provided by leading scholars who had yet to publish their data; (e) all manuscripts were written in English; and (f) studies included the Pearson Product Moment Correlation Coefficient ( r) for the effect size. Criteria for review: We systematically coded for the following items for each study: year of publication, type of report, peer-reviewed, funding, sampling strategy, sample size, gender, mean age, country of study, measure of resilience, measure depression, and measure of childhood trauma. Major findings: The pooled correlations indicate that trauma, resilience, and depression are significantly associated. There were no significant differences in symptoms of depression for high versus low reports of resilience for individuals with a history of trauma. Year of publication was a significant moderator for the associations between trauma, resilience, and depression. Resilience significantly mediated the association between trauma and depression.

Contributions of Meta-analysis to Conservation and Management

2013 ◽  
Author(s):  
Isabelle M. Côté ◽  
Gavin B. Stewart
Keyword(s):  
Decision Making ◽  
Systematic Reviews ◽  
Large Scale ◽  
Meta Analysis ◽  
Conservation Policy ◽  
Small Scale ◽  
Management Interventions ◽  
History Of ◽  
Meta Analyses ◽  
Conservation And Management

This chapter looks back through the relatively short history of meta-analyses and systematic reviews of conservation interest and highlights four areas to which these methods have contributed significantly. These include challenging conventional wisdom, measuring effectiveness of management interventions, replacing large-scale monitoring with small-scale surveys, and identifying gaps in knowledge. The chapter shows that meta-analyses and systematic reviews have contributed to answering a number of important applied questions. However, although these answers often have clear implications for conservation policy and legislation, they currently remain the focus of primarily academic interest. Given a little more time, evidence bases that are collated using systematic reviews, particularly in association with meta-analysis, are expected to increasingly influence decision making in the environmental sector, just as they have in medical fields.

scholarly journals Increased Risk of Asthma and Allergic Rhinitis in Patients With a Past History of Kawasaki Disease: A Systematic Review and Meta-Analyses

2021 ◽  
Vol 9 ◽  
Author(s):  
Wei-Te Lei ◽  
Chih-Wei Hsu ◽  
Po-Cheng Chen ◽  
Ping-Tao Tseng ◽  
Ho-Chang Kuo ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Atopic Dermatitis ◽  
Kawasaki Disease ◽  
Past History ◽  
Meta Analysis ◽  
Allergic Diseases ◽  
Previous Diagnosis ◽  
Increased Risk ◽  
History Of ◽  
Meta Analyses

Background: Allergic diseases are frequently observed in children with Kawasaki disease (KD). However, the evidence supporting the association between KD and allergies has been conflicting. The objective of the current study is to examine the association between KD and allergic diseases.Methods: We conducted an electronic search using PubMed, Embase, and the Cochrane through 24 July 2021. The inclusion criteria consisted of studies that examined the prevalence of allergic diseases in children with a previous diagnosis of KD and in a comparison group. We pooled studies by using a random effects model. The effects of KD on the subsequent risk of allergic diseases were expressed as odds ratio (OR) with 95% confidence intervals (CI).Results: We included a total of four studies that assessed the effect of KD on asthma, allergic rhinitis, and atopic dermatitis vs. non-KD children (KD individuals for asthma, four studies, n = 8,474; allergic rhinitis, four studies, n = 8,474; atopic dermatitis, three studies, n = 8,330). The overall prevalence of asthma, allergic rhinitis, and atopic dermatitis was 9.12, 27.63, and 6.55% among patients with previous KD. The meta-analysis showed a significantly increased risk of asthma (OR:1.437, CI: 1.067–1.937) and allergic rhinitis (OR: 1.726, CI: 1.291–2.307) in patients with KD, compared with the control groups. However, patients with KD did not have a significantly different level of risk of atopic dermatitis (OR: 1.243, 95% CI: 0.857–1.802).Conclusion: This meta-analysis supports that individuals with KD are more likely to have asthma and allergic rhinitis compared to controls.

A Meta-Analysis of Interviews and Cognitive Ability

2013 ◽  
Vol 12 (4) ◽  
pp. 157-169 ◽  
Author(s):  
Philip L. Roth ◽  
Allen I. Huffcutt
Keyword(s):  
Cognitive Ability ◽  
Meta Analysis ◽  
Incremental Validity ◽  
Employment Interviews ◽  
Moderator Analysis ◽  
The Future ◽  
Research Questions ◽  
Meta Analyses ◽  
The Relationship

The topic of what interviews measure has received a great deal of attention over the years. One line of research has investigated the relationship between interviews and the construct of cognitive ability. A previous meta-analysis reported an overall corrected correlation of .40 ( Huffcutt, Roth, & McDaniel, 1996 ). A more recent meta-analysis reported a noticeably lower corrected correlation of .27 ( Berry, Sackett, & Landers, 2007 ). After reviewing both meta-analyses, it appears that the two studies posed different research questions. Further, there were a number of coding judgments in Berry et al. that merit review, and there was no moderator analysis for educational versus employment interviews. As a result, we reanalyzed the work by Berry et al. and found a corrected correlation of .42 for employment interviews (.15 higher than Berry et al., a 56% increase). Further, educational interviews were associated with a corrected correlation of .21, supporting their influence as a moderator. We suggest a better estimate of the correlation between employment interviews and cognitive ability is .42, and this takes us “back to the future” in that the better overall estimate of the employment interviews – cognitive ability relationship is roughly .40. This difference has implications for what is being measured by interviews and their incremental validity.

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