Intervention effects in the case of heterogeneity between three subgroups. Assessment within the framework of systematic reviews

Methods of Information in Medicine
Guido Skipka, R Bender

Abstract

Usually, statistical tests for interactions are applied to investigate potential effect modifiers. If an effect modifier, consisting of three categories, is found to be statistically significant, the application of pairwise interaction tests is indicated. In this case, the problem of non-transitive relations may occur if the significance level is fixed at 0.05 for all tests. To develop an algorithm for which non-transitive relations do not occur. A hierarchical testing procedure is applied, based on the heterogeneity statistic Q. In a first step the interaction will be tested for the three trial subgroups altogether, applying the significance level α = 0.05 (global test). If a significant interaction is proven in the first step, pairwise tests for interaction will be applied in a second step. Theoretical data scenarios will be considered and p-values will be calculated for the pairwise tests. Based on these results the significance level for pairwise testing will be determined. Fixing the significance level at 0.05 for all tests, the problem of non-transitive relations is mostly relevant, if the difference in the effects between the three trial subgroups is approximately 3.5 standard errors and the effect of the 'middle' trial ...Continue Reading

Citations

Aug 1, 2012·BMC Medical Research Methodology·Joel J GagnierClaire Bombardier
Apr 4, 2015·Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen·Andrej Rasch, Charalabos-Markos Dintsios

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