Evidence map›Paper›PMID 29696231›Full record

ArticleContemporary clinical trials communications2018

Interval estimation of the overall treatment effect in a meta-analysis of a few small studies with zero events.

Konstantinos Pateras, Stavros Nikolakopoulos, Dimitris Mavridis, Kit C B Roes

Open access · goldAbstract read
In one paragraph

Article in Contemporary clinical trials communications, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 4 pooled it
2.9field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 4 syntheses or guidelines pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Bayesian Meta-Analysis for Binary Data and Prior Distribution on Models.International journal of environmental research and public health · 2021
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 2 countries.

Konstantinos PaterasDepartment of Biostatistics and Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
Stavros NikolakopoulosDepartment of Biostatistics and Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
Dimitris MavridisDepartment of Primary Education, School of Medicine, University of Ioannina, University Campus, 45110 Ioannina, Greece.
Kit C B RoesDepartment of Biostatistics and Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
University Medical Center Utrecht · NLUniversity of Ioannina · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

When a meta-analysis consists of a few small trials that report zero events, accounting for heterogeneity in the (interval) estimation of the overall effect is challenging. Typically, we predefine meta-analytical methods to be employed. In practice, data poses restrictions that lead to deviations from the pre-planned analysis, such as the presence of zero events in at least one study arm. We aim to explore heterogeneity estimators behaviour in estimating the overall effect across different levels of sparsity of events. We performed a simulation study that consists of two evaluations. We considered an overall comparison of estimators unconditional on the number of observed zero cells and an additional one by conditioning on the number of observed zero cells. Estimators that performed modestly robust when (interval) estimating the overall treatment effect across a range of heterogeneity assumptions were the Sidik-Jonkman, Hartung-Makambi and improved Paul-Mandel. The relative performance of estimators did not materially differ between making a predefined or data-driven choice. Our investigations confirmed that heterogeneity in such settings cannot be estimated reliably. Estimators whose performance depends strongly on the presence of heterogeneity should be avoided. The choice of estimator does not need to depend on whether or not zero cells are observed.

Indexed as

HeterogeneityMeta-analysisRare diseasesSmall populationsZero events

Identifiers

PMID29696231
PMCPMC5898531
OpenAlexW2784015963

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.