Meta-Analysis

G.Leandro Meta-Analysis The handbook for the understanding and practice of Meta-Analysis

 

This product will be available soon

 






Presentation

Today, clinicians are more and more involved in conducting and evaluating results of diagnostic tests, procedures and clinical trials. Clinicians realise that to do this properly it is necessary to be aquainted with the main features and methodology of statistics applied to these areas.
During the last few years, although there has been a slow progress towards an evidence based practice of medicine, the current situation is far from satisfactory.
Among the principal reasons why the slow progress is being made is the lack of knowledge in the use of mathematical and statistical tools and thus the tendency to avoid using these.
Those who can help remedy this situation are clinicians who have acquired this knowledge and who can not only communicate with their colleagues using appropriate terminology, but also present the information in a way best suited to their colleagues.
This guide to meta-analysis is the work of a clinician and is aimed at dealing with the difficulties mentioned above.
The reader is introduced to the main aspects of meta analysis using simple terminology, but avoiding a simplistic approach.
There are examples of the most common errors made in its use.
The programme is designed for ease of use, which will help clinicians to utilize meta-analysis.
The handbook contains a small chapter dedicated to the statistical procedures which assumes that the reader has a knowledge of the basic points of statistical methods, but could also prove interesting and informative to those who are currently learning or who are consolidating their statistical knowledge.
The author's choice to concentrate on a practical guide is justified as he has dealt with this extensively, rather than concentrating on describing statistical methods.
I am therefore very pleased to present this handbook of meta analysis, in the certainty that it will be a success.

Prof. Giuseppe GALLUS
University of Milan - Italy





Preface

This handbook and accompanying program META, is divided into three parts: the first deals with meta-analysis, the second illustrates some examples and the third is the users manual.
The first part, even though it describes statistical methodology in detail, is necessary for a good understanding of meta - analysis. It does not substitute the classic texts on meta - analysis, but is intended to help users to understand the main principles and to encourage them to become aquainte with the subject and to guide them in the optimal use of the program.
The program contains very useful functions such as re-ordering and correction of the archives, cumulative meta analysis, Number needed to Treat (NnT), Publication Bias Assessment and graphics (eg. the Galbraith plot for the odds ratio and risk difference and the cumulative Meta-Analysis).
The handbook allows the reader to integrate clinical and statistical methods and can be used as a tool for teaching both practical and theoretical aspects of meta analysis.
The reader should be able to carry out a formal meta analysis, report the results and be able to interpret these correctly. Where a more detailed evaluation is desired the reader is advised to look up the texts or articles referred to in the bibliography.
The second part shows examples of meta analysis analysed both from the meta-analytical stand point and also from the methodological view point, illustrating the various functions described in the handbook.



Contents

 

PRESENTATION .............................................................................. ..........................................  7
PREFACE ........................................................................................... ..........................................  9
     
     
PART ONE ........................................................................................ ......................................... 11
     
  INTRODUCTION ........................................................................... ......................................... 13
  A BRIEF HISTORY ........................................................................ ......................................... 17
  OBJECTIVES ................................................................................... ......................................... 19
  PHASES OF A META-ANALYSIS TEST .................................. ......................................... 21
  DIAS IN SEARCH IN META-ANALYSIS ................................. ......................................... 29
  APPENDIX ...................................................................................... ......................................... 37
  STATISTICAL PROCEDURES .................................................... ......................................... 39
    Fixed effects models ..................................................................... ......................................... 40
    Random effects models ............................................................... ......................................... 47
  OPERETING PROCEDURES ......................................................... ......................................... 49
    Control of data .............................................................................. ......................................... 49
    Graphical rappresentation ........................................................... ......................................... 51
    Numerical output .......................................................................... ......................................... 60
     
     
PART TWO ....................................................................................... ......................................... 69
     
  5-ASA IN CROHN'S DISEASE ..................................................... ......................................... 71
  OMEPRAZOLE VS. H-2 ANTAGONIST    
  IN THE THERAPY OF GRASTRIC ULCER .............................. ..........................................  77
  META-ANALYSIS IN LITERATURE: REFLECTION    
  ON STATISTICAL HETEROGENITY ....................................... ..........................................  83
  PROTON PUMP INHIBITORS (PPI) IN THE PREVENTIONS    
  OF SEVERE ACUTE NSAID-RELATE STRIC DAMAGE IN    
  HEALTY SUBJECTS ................................................................... ..........................................  87
  HOW TO PRESENT A META-ANALYSIS .............................. ..........................................  89
     
REFERENCES .................................................................................. ..........................................  95
     
     
PART TREE ..................................................................................... ..........................................  97
     
 CHAPTER 1 .................................................................................... ..........................................  99
  GENERAL INFORMATION ........................................................ ..........................................  99
    Minimum requirements .............................................................. ..........................................  99
    Structure of the Program ............................................................ ......................................... 100
    Principal Characteristics ............................................................ ......................................... 100
    General user interfaces ............................................................... ......................................... 101
 CHAPTER 2 .................................................................................... ......................................... 109
  INSTALLATION .......................................................................... ......................................... 109
 CHAPTER 3 .................................................................................... ......................................... 111
  STARTING UP .............................................................................. ......................................... 111
 CHAPTER 4 .................................................................................... ......................................... 115
  PROCEDURES ............................................................................... ......................................... 115
    Organization of studies in the tables ....................................... ......................................... 115
    Statistical elaboration of studies .............................................. ......................................... 121
    Display of the numerical result ................................................. .......................................... 127
    Display of graph ......................................................................... ......................................... 128
 CHAPTER 5 .................................................................................... ......................................... 133
  RESTORING THE ARCHIVES .................................................... ......................................... 133
 CHAPTER 6 .................................................................................... ......................................... 135
  COPY/RESTORE ........................................................................... ......................................... 135
    Copy from hard disk to floppy ................................................. ......................................... 136
    Restore from floppy to hard disk ............................................. ......................................... 137
    Formatting new disk ................................................................... ......................................... 137
    Set up for the copy ..................................................................... ......................................... 137
    Restore from automatic copy .................................................... ......................................... 139
 CHAPTER 7 .................................................................................... ......................................... 141
  SET UP THE VARIUS PARAMETERS ..................................... ......................................... 141
    Setting up of tables of the studies ........................................... ......................................... 141
    Set up of the output ................................................................... ......................................... 142
    Setting up the paper directory .................................................. ......................................... 142
    Setting up for the screen ........................................................... ......................................... 143
    Time and date of the system ..................................................... ......................................... 147
    Passwords to access the data .................................................. ......................................... 148
    Setting up the printer ................................................................. ......................................... 149