Elsevier

Controlled Clinical Trials

Volume 7, Issue 3, September 1986, Pages 177-188
Controlled Clinical Trials

Meta-analysis in clinical trials

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Abstract

This paper examines eight published reviews each reporting results from several related trials. Each review pools the results from the relevant trials in order to evaluate the efficacy of a certain treatment for a specified medical condition. These reviews lack consistent assessment of homogeneity of treatment effect before pooling. We discuss a random effects approach to combining evidence from a series of experiments comparing two treatments. This approach incorporates the heterogeneity of effects in the analysis of the overall treatment efficacy. The model can be extended to include relevant covariates which would reduce the heterogeneity and allow for more specific therapeutic recommendations. We suggest a simple noniterative procedure for characterizing the distribution of treatment effects in a series of studies.

Keywords

random effects model
heterogeneity of treatment effects
distribution of treatment effects
covariate information

Cited by (0)

This research was supported by grant CA09424-03 from the National Cancer Institute and grant GM-29745 from the National Institute of Health. We are grateful to Frederick Mosteller, Tom Louis, and Katherine Halvorsen for critical readings of various drafts, encouragement, and advice.