Borrowing strength from external trials in a meta-analysis.

Abstract

There exists a variety of situations in which a random effects meta-analysis might be undertaken using a small number of clinical trials. A problem associated with small meta-analyses is estimating the heterogeneity between trials. To overcome this problem, information from other related studies may be incorporated into the meta-analysis. A Bayesian approach to this problem is presented using data from previous meta-analyses in the same therapeutic area to formulate a prior distribution for the heterogeneity. The treatment difference parameters are given non-informative priors. Further, related trials which compare one or other of the treatments of interest with a common third treatment are included in the model to improve inference on both the heterogeneity and the treatment difference. Two approaches to estimating relative efficacy are considered, namely a general parametric approach and a method explicit to binary data. The methodology is illustrated using data from 26 clinical trials which investigate the prevention of cirrhosis using beta-blockers and sclerotherapy. Both sources of external information lead to more precise posterior distributions for all parameters, in particular that representing heterogeneity.

• Authors: J P Higgins, A Whitehead
• Journal: Statistics in medicine (Stat Med) Vol. 15 Issue 24 Pg. 2733-49 (Dec 30 1996) ISSN: 0277-6715 [Print] England
• PMID: 8981683 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Adrenergic beta-Antagonists

Topics

• Adrenergic beta-Antagonists (therapeutic use)
• Bayes Theorem
• Data Interpretation, Statistical
• Gastrointestinal Hemorrhage (prevention & control)
• Humans
• Likelihood Functions
• Liver Cirrhosis (complications)
• Meta-Analysis as Topic
• Models, Statistical
• Multivariate Analysis
• Odds Ratio
• Randomized Controlled Trials as Topic (methods)
• Sclerotherapy