Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 1 - 8 |
| Number of pages | 8 |
| Journal | Critical Care |
| Volume | 12 |
| Issue number | 220 |
| DOIs | |
| Publication status | Published - 2008 |
Cite this
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Bench-to-bedside review: avoiding pitfalls in critical care meta-analysis - funnel plots, risk estimates, types of heterogeneity, baseline risk and the ecologic fallacy. / Reade, Michael; Delaney, Anthony; Bailey, Michael; Angus, Derek.
In: Critical Care, Vol. 12, No. 220, 2008, p. 1 - 8.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Bench-to-bedside review: avoiding pitfalls in critical care meta-analysis - funnel plots, risk estimates, types of heterogeneity, baseline risk and the ecologic fallacy
AU - Reade, Michael
AU - Delaney, Anthony
AU - Bailey, Michael
AU - Angus, Derek
PY - 2008
Y1 - 2008
N2 - Meta-analysis can be a powerful tool for demonstrating the applicability of a concept beyond the context of individual clinical trials and observational studies, including exploration of effects across different subgroups. Meta-analysis avoids Simpsona??s paradox, in which a consistent effect in constituent trials is reversed when results are simply pooled. Meta-analysis in critical care medicine is made more complicated, however, by the heterogeneous nature of critically ill patients and the contexts within which they are treated. Failure to properly adjust for this heterogeneity risks missing important subgroup effects in, for example, the interaction of treatment with varying levels of baseline risk. When subgroups are defined by characteristics that vary within constituent trials (such as age) rather than features constant within each trial (such as drug dose), there is the additional risk of incorrect conclusions due to the ecological fallacy. The present review explains these problems and the strategies by which they are overcome.
AB - Meta-analysis can be a powerful tool for demonstrating the applicability of a concept beyond the context of individual clinical trials and observational studies, including exploration of effects across different subgroups. Meta-analysis avoids Simpsona??s paradox, in which a consistent effect in constituent trials is reversed when results are simply pooled. Meta-analysis in critical care medicine is made more complicated, however, by the heterogeneous nature of critically ill patients and the contexts within which they are treated. Failure to properly adjust for this heterogeneity risks missing important subgroup effects in, for example, the interaction of treatment with varying levels of baseline risk. When subgroups are defined by characteristics that vary within constituent trials (such as age) rather than features constant within each trial (such as drug dose), there is the additional risk of incorrect conclusions due to the ecological fallacy. The present review explains these problems and the strategies by which they are overcome.
U2 - 10.1186/cc6941
DO - 10.1186/cc6941
M3 - Article
VL - 12
SP - 1
EP - 8
JO - Critical Care
JF - Critical Care
SN - 1364-8535
IS - 220
ER -