如何进行Meta分析-加尔各答.pptVIP

How to Abstract Data: Guidelines Create a spreadsheet (Excel, or OpenOffice Calc) For each study, create the following columns: name of the study name of the author, year published number of participants who received intervention number of participants who were in control arm number who developed outcomes in intervention number who developed outcomes in control arm Let’s do that to our streptokinase myocardial infarction study, next … Spreadsheet Data for Strepto Study We created seven columns trial: trial identity code trialname: name of trial year: year of the study pop1: study population deaths1: deaths in study pop0: control population deaths0: deaths in control We got like 22 studies to do our meta analysis, after all Analyze Data Statistically Combine data to arrive at a summary, 3 measures Effect Size (Odds Ratio) Variance with 95% Confidence Interval Test of heterogeneity Two Graphs Forest Plot Funnel Plot Examine why the studies are heterogeneous, if they are Use Statistical Packages, several choices Let’s see what we got for streptokinase versus deaths from AMI Summary Estimates for Strepto Study Mantel Haenszel OR=0.77 95% Confidence Interval [0.72, 0.83] Test of Heterogeneity: Chi-square (df=21) = 31.5 P-Value = 0.07 The pooled Odds Ratio shows that those receiving streptokinase at AMI are about 77% at risk of death (23% less likely to die) That in 95 out of 100 such meta analyses, the pooled Odds Ratio would lie between 0.72 and 0.83, indicating a statistically significant protective effect That these studies were not significantly heterogeneous Forest Plot The dotted line passes across null, or 1.0 The Risk Estimate of each study is lined up on each side of the dotted line, with 95% CI spread as the line The diamond in the below is the summary estimate The two ends of the diamond indicate 95% CI They call it a forest plot so that you don’t miss the wood for the trees! The size of the black square box indicates weight of the study How to do Meta