Abstract
Meta-analyses of observational studies are frequently published in the literature, but they are generally considered suboptimal to those involving randomised controlled trials (RCTs) only. This is due to the increased risk of biases that observational studies may entail as well as because of the high heterogeneity that might be present. In this article, we highlight aspects of meta-analyses with observational studies that need more careful consideration in comparison to meta-analyses of RCTs. We present an overview of recommendations from the literature with respect to how the different steps of a meta-analysis involving observational studies should be comprehensively conducted. We focus more on issues arising at the step of the quantitative synthesis, in terms of handling heterogeneity and biases. We briefly describe some sophisticated synthesis methods, which may allow for more flexible modelling approaches than common meta-analysis models. We illustrate the issues encountered in the presence of observational studies using an example from mental health, which assesses the risk of myocardial infarction in antipsychotic drug users. The increased heterogeneity observed among studies challenges the interpretation of the diamond, ...Continue Reading
References
Feb 14, 1998·BMJ : British Medical Journal·M EggerG Davey Smith
Aug 12, 1999·Statistics in Medicine·B A BrumbackL M Ryan
May 2, 2000·JAMA : the Journal of the American Medical Association·D F StroupS B Thacker
Dec 21, 2000·Statistics in Medicine·T C PrevostD R Jones
Jan 11, 2005·Lancet·Peter M Rothwell
Aug 9, 2005·Journal of Clinical Epidemiology·Adina R LemeshowGraham A Colditz
Apr 22, 2009·Journal of the Royal Statistical Society. Series A, (Statistics in Society)·Rebecca M TurnerSimon G Thompson
Feb 9, 2010·BMJ : British Medical Journal·Richard D RileyGhada Abo-Zaid
Dec 28, 2010·International Journal of Epidemiology·Simon ThompsonDésirée Wilks
Jun 5, 2012·The British Journal of Psychiatry : the Journal of Mental Science·Traolach S BrughaDavid R Jones
Feb 27, 2013·Statistics in Medicine·Susanne SchmitzCathal Walsh
May 2, 2014·The Cochrane Database of Systematic Reviews·Andrew AnglemyerLisa Bero
Jun 4, 2015·Research Synthesis Methods·Pablo E Verde, Christian Ohmann
May 21, 2016·British Journal of Clinical Pharmacology·Zheng-He YuBing Ruan
Oct 14, 2016·BMJ : British Medical Journal·Jonathan Ac SterneJulian Pt Higgins
Jan 14, 2017·Statistics in Medicine·Orestis EfthimiouUNKNOWN GetReal Work Package 4
Mar 9, 2018·Nature·Jessica GurevitchGavin Stewart
May 23, 2018·BMC Medical Research Methodology·Monika MuellerPippa Scott
Oct 27, 2018·F1000Research·Sophie GrahamSreeram Ramagopalan
Mar 25, 2019·BMC Research Notes·Joeri KalterLaurien M Buffart
Apr 2, 2019·Saudi Journal of Anaesthesia·Sarah Cuschieri
Citations
Dec 15, 2020·BMC Medical Informatics and Decision Making·Ruohua YanXiaoxia Peng
Jan 20, 2021·Brachytherapy·Gustavo Arruda VianiLigia Issa De Fendi
Nov 25, 2020·Journal of Clinical Medicine·Tai-Li ChenKuei-Ying Su
Feb 2, 2021·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Deborah Obeng-TuudahRezan Abdul Kadir
Mar 22, 2021·Rheumatology International·Kendrick ToWasim Khan
Mar 23, 2021·BMC Research Notes·Jaameeta KurjiZohra Lassi
Mar 30, 2021·Journal of Clinical Epidemiology·Ioannis Bellos
Apr 8, 2021·JAMA Surgery·Benjamin S BrookeTimothy M Pawlik
Apr 15, 2021·Evidence-based Mental Health·Robert McCutcheonOliver Howes
Apr 27, 2021·Journal of Dairy Science·S BuczinskiE Timsit
Mar 12, 2021·Aesthetic Surgery Journal·Seied Omid KeyhanJulian Yates
May 19, 2021·PloS One·Lakshmi ManoharanPiero Olliaro
May 28, 2021·JAMA Otolaryngology-- Head & Neck Surgery·Phillip StaibanoDoron D Sommer
May 25, 2021·Acta Psychiatrica Scandinavica·Natalie ShohamClaudia Cooper
Jun 30, 2021·PloS One·Joshua LiawClare Heal
Jul 20, 2021·Langenbeck's Archives of Surgery·Yu CaoYingxin Fu
Jul 11, 2021·Journal of Orthopaedic Surgery and Research·Mattia ZappaláNicola R Heneghan
Aug 3, 2021·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Corinne S BabiolakisWael Abuzeid
Aug 14, 2021·Aesthetic Surgery Journal·Seied Omid KeyhanJulian Yates
Jun 11, 2021·Sexually Transmitted Diseases·Aikaterini TsentemeidouNikolaos Tsetsos
Aug 20, 2021·Health Psychology Review·Chiara GasteigerKeith J Petrie
Sep 2, 2021·The Science of the Total Environment·Jingwen LiuPeng Bi
Oct 15, 2021·Postgraduate Medical Journal·Chung Mun Alice LinDavid J Deehan
Oct 14, 2021·Human Reproduction Update·Laura A WijsRoger J Hart