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Random-effects meta-analysis of few studies involving rare events

dc.contributor.authorGünhan, Burak Kürsad
dc.contributor.authorRöver, Christian
dc.contributor.authorFriede, Tim
dc.date.accessioned2020-01-17T09:50:02Z
dc.date.available2020-01-17T09:50:02Z
dc.date.issued2019-07-26de
dc.relation.ISSN1759-2887de
dc.identifier.urihttp://resolver.sub.uni-goettingen.de/purl?gs-1/17121
dc.description.abstractMeta-analyses of clinical trials targeting rare events face particular challenges when the data lack adequate numbers of events for all treatment arms. Especially when the number of studies is low, standard random-effects meta-analysis methods can lead to serious distortions because of such data sparsity. To overcome this, we suggest the use of weakly informative priors (WIPs) for the treatment effect parameter of a Bayesian meta-analysis model, which may also be seen as a form of penalization. As a data model, we use a binomial-normal hierarchical model (BNHM) that does not require continuity corrections in case of zero counts in one or both arms. We suggest a normal prior for the log-odds ratio with mean 0 and standard deviation 2.82, which is motivated (a) as a symmetric prior centered around unity and constraining the odds ratio within a range from 1/250 to 250 with 95% probability and (b) as consistent with empirically observed effect estimates from a set of 37 773 meta-analyses from the Cochrane Database of Systematic Reviews. In a simulation study with rare events and few studies, our BNHM with a WIP outperformed a Bayesian method without a WIP and a maximum likelihood estimator in terms of smaller bias and shorter interval estimates with similar coverage. Furthermore, the methods are illustrated by a systematic review in immunosuppression of rare safety events following pediatric transplantation. A publicly available R package, MetaStan, is developed to automate a Bayesian implementation of meta-analysis models using WIPs.de
dc.languageeng
dc.language.isoengde
dc.rightsopenAccess
dc.rightsNamensnennung - Weitergabe unter gleichen Bedingungen 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by-sa/4.0/*
dc.subjectBayes; few studies; random-effects meta-analysis; rare events; weakly informative priorsde
dc.subject.ddc610
dc.titleRandom-effects meta-analysis of few studies involving rare eventsde
dc.typejournalArticlede
dc.identifier.doi10.1002/jrsm.1370
dc.type.versionpublishedVersionde
dc.bibliographicCitation.volume11de
dc.bibliographicCitation.issue1de
dc.bibliographicCitation.firstPage74de
dc.bibliographicCitation.lastPage90de
dc.type.subtypejournalArticle
dc.identifier.pmid31348846
dc.description.statuspeerReviewedde
dc.bibliographicCitation.journalResearch Synthesis Methodsde


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