Bayesian meta-analysis on medical devices: application to implantable cardioverter defibrillators.

International Journal of Technology Assessment in Health Care
Ji-Hee YounMartin Buxton

Abstract

The aim of this study is to describe and illustrate a method to obtain early estimates of the effectiveness of a new version of a medical device. In the absence of empirical data, expert opinion may be elicited on the expected difference between the conventional and modified devices. Bayesian Mixed Treatment Comparison (MTC) meta-analysis can then be used to combine this expert opinion with existing trial data on earlier versions of the device. We illustrate this approach for a new four-pole implantable cardioverter defibrillator (ICD) compared with conventional ICDs, Class III anti-arrhythmic drugs, and conventional drug therapy for the prevention of sudden cardiac death in high risk patients. Existing RCTs were identified from a published systematic review, and we elicited opinion on the difference between four-pole and conventional ICDs from experts recruited at a cardiology conference. Twelve randomized controlled trials were identified. Seven experts provided valid probability distributions for the new ICDs compared with current devices. The MTC model resulted in estimated relative risks of mortality of 0.74 (0.60-0.89) (predictive relative risk [RR] = 0.77 [0.41-1.26]) and 0.83 (0.70-0.97) (predictive RR = 0.84 [0.55-1.22...Continue Reading

References

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Citations

Apr 23, 2013·International Journal of Technology Assessment in Health Care·Leslie Pibouleau, Sylvie Chevret
May 7, 2014·Journal of Pediatric Gastroenterology and Nutrition·Stephen B FreedmanSuzanne Schuh
Dec 15, 2015·Journal of Pediatric Gastroenterology and Nutrition·Corrie E ChumpitaziBruno P Chumpitazi
Jun 29, 2018·Journal of Pediatric Gastroenterology and Nutrition·Line ModinMarianne Skytte Jakobsen
Apr 18, 2013·Journal of Pediatric Gastroenterology and Nutrition·Arik Alper, Dinesh S Pashankar

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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

Excel
R
WinBUGS

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