Meta-analytic methods for pooling rates when follow-up duration varies: a case study

BMC Medical Research Methodology
James P GuevaraFredric M Wolf

Abstract

Meta-analysis can be used to pool rate measures across studies, but challenges arise when follow-up duration varies. Our objective was to compare different statistical approaches for pooling count data of varying follow-up times in terms of estimates of effect, precision, and clinical interpretability. We examined data from a published Cochrane Review of asthma self-management education in children. We selected two rate measures with the largest number of contributing studies: school absences and emergency room (ER) visits. We estimated fixed- and random-effects standardized weighted mean differences (SMD), stratified incidence rate differences (IRD), and stratified incidence rate ratios (IRR). We also fit Poisson regression models, which allowed for further adjustment for clustering by study. For both outcomes, all methods gave qualitatively similar estimates of effect in favor of the intervention. For school absences, SMD showed modest results in favor of the intervention (SMD -0.14, 95% CI -0.23 to -0.04). IRD implied that the intervention reduced school absences by 1.8 days per year (IRD -0.15 days/child-month, 95% CI -0.19 to -0.11), while IRR suggested a 14% reduction in absences (IRR 0.86, 95% CI 0.83 to 0.90). For ER vi...Continue Reading

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Citations

Oct 30, 2012·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Sofia DiasNicky J Welton
Jul 30, 2008·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Natalie OakeCarl van Walraven
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Sep 9, 2015·The Cochrane Database of Systematic Reviews·Regina I Ejemot-NwadiaroJulia A Critchley
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Mar 15, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Sergio BuccheriDavide Capodanno
Jun 23, 2019·Clinical Drug Investigation·Yi ShenPengcheng Xun
Feb 5, 2021·The Cochrane Database of Systematic Reviews·Regina I Ejemot-NwadiaroJulia A Critchley
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Oct 10, 2020·JACC. Cardiovascular Interventions·Nagendra Boopathy Senguttuvan, Rama Jayaraj

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