Addressing continuous data measured with different instruments for participants excluded from trial analysis: a guide for systematic reviewers
Por:
Ebrahim, S, Johnston, BC, Akl, EA, Mustafa, RA, Sun, X, Walter, SD, Heels-Ansdell, D, Alonso-Coello, P, Guyatt, GH
Publicada:
1 may 2014
Resumen:
Background: We previously developed an approach to address the impact of missing participant data in meta-analyses of continuous variables in trials that used the same measurement instrument. We extend this approach to meta-analyses including trials that use different instruments to measure the same construct.
Methods: We reviewed the available literature, conducted an iterative consultative process, and developed an approach involving a complete-case analysis complemented by sensitivity analyses that apply a series of increasingly stringent assumptions about results in patients with missing continuous outcome data.
Results: Our approach involves choosing the reference measurement instrument; converting scores from different instruments to the units of the reference instrument; developing four successively more stringent imputation strategies for addressing missing participant data; calculating a pooled mean difference for the complete-case analysis and imputation strategies; calculating the proportion of patients who experienced an important treatment effect; and judging the impact of the imputation strategies on the confidence in the estimate of effect. We applied our approach to an example systematic review of respiratory rehabilitation for chronic obstructive pulmonary disease.
Conclusions: Our extended approach provides quantitative guidance for addressing missing participant data in systematic reviews of trials using different instruments to measure the same construct. (C) 2014 Elsevier Inc. All rights reserved.
Filiaciones:
Ebrahim, S:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8S 4K1, Canada
McMaster Univ, Dept Anesthesia, Hamilton, ON L8S 4K1, Canada
Stanford Univ, Dept Med, Stanford Prevent Res Ctr, Stanford, CA 94305 USA
Hosp Sick Children, Dept Anesthesia & Pain Med, Toronto, ON M5G 1X8, Canada
Johnston, BC:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8S 4K1, Canada
Hosp Sick Children, Dept Anesthesia & Pain Med, Toronto, ON M5G 1X8, Canada
Hosp Sick Children, Res Inst, Toronto, ON M5G 1X8, Canada
Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON M5T 3M6, Canada
Akl, EA:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8S 4K1, Canada
Amer Univ Beirut, Dept Internal Med, Beirut, Lebanon
SUNY Buffalo, Dept Med, Buffalo, NY 14215 USA
Mustafa, RA:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8S 4K1, Canada
Univ Missouri, Dept Med, Kansas City, MO 64110 USA
Sun, X:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8S 4K1, Canada
Xinqiao Hosp, Ctr Clin Epidemiol & Evidence Based Med, Chongqing, Peoples R China
Walter, SD:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8S 4K1, Canada
Heels-Ansdell, D:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8S 4K1, Canada
Alonso-Coello, P:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8S 4K1, Canada
CIBERESP IIB St Pau, Iberoamer Cochrane Ctr, Barcelona 08025, Spain
Guyatt, GH:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8S 4K1, Canada
McMaster Univ, Dept Med, Hamilton, ON L8S 4K1, Canada
|