Evidence map›Paper›PMID 31058440›Full record

SynthesisResearch synthesis methods2019

Empirical comparison of univariate and multivariate meta-analyses in Cochrane Pregnancy and Childbirth reviews with multiple binary outcomes.

Malcolm J Price, Helen A Blake, Sara Kenyon, Ian R White, Dan Jackson, Jamie J Kirkham, James P Neilson, Jonathan J Deeks, Richard D Riley

Abstract readComparative StudyMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Research synthesis methods, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 5 pooled it
–field-weighted citation impact
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

6 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Review
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

9 authors.

Malcolm J PriceInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.ORCID https://orcid.org/0000-0002-7352-3027
Helen A BlakeDepartment of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.ORCID https://orcid.org/0000-0001-7856-5931
Sara KenyonInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Ian R WhiteMRC Clinical Trials Unit, University College London, London, UK.
Dan JacksonStatistical Innovation Group, AstraZeneca, Cambridge, UK.ORCID https://orcid.org/0000-0002-4963-8123
Jamie J KirkhamDepartment of Biostatistics, University of Liverpool, Liverpool, UK.
James P NeilsonCochrane Pregnancy & Childbirth Group, Centre for Women's Health Research, University of Liverpool, Liverpool, UK.
Jonathan J DeeksInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Richard D RileyCentre for Prognosis Research, Research Institute for Primary Care & Health Sciences, Keele University, UK.ORCID https://orcid.org/0000-0001-8699-0735

Funding

Medical Research Council MC_UU_12023/21Medical Research Council MR/J013595/1NIHR CLAHRC West Midlands+
6 · The paper itself

Abstract

backgroundMultivariate meta-analysis (MVMA) jointly synthesizes effects for multiple correlated outcomes. The MVMA model is potentially more difficult and time-consuming to apply than univariate models, so if its use makes little difference to parameter estimates, it could be argued that it is redundant.

methodsWe assessed the applicability and impact of MVMA in Cochrane Pregnancy and Childbirth (CPCB) systematic reviews. We applied MVMA to CPCB reviews published between 2011 and 2013 with two or more binary outcomes with at least three studies and compared findings with results of univariate meta-analyses. Univariate random effects meta-analysis models were fitted using restricted maximum likelihood estimation (REML).

resultsEighty CPCB reviews were published. MVMA could not be applied in 70 of these reviews. MVMA was not feasible in three of the remaining 10 reviews because the appropriate models failed to converge. Estimates from MVMA agreed with those of univariate analyses in most of the other seven reviews. Statistical significance changed in two reviews: In one, this was due to a very small change in P value; in the other, the MVMA result for one outcome suggested that previous univariate results may be vulnerable to small-study effects and that the certainty of clinical conclusions needs consideration.

conclusionsMVMA methods can be applied only in a minority of reviews of interventions in pregnancy and childbirth and can be difficult to apply because of missing correlations or lack of convergence. Nevertheless, clinical and/or statistical conclusions from MVMA may occasionally differ from those from univariate analyses.

Indexed as

Labor, ObstetricMeta-Analysis as TopicParturitionResearch DesignReview Literature as TopicAnesthesia, ConductionAnesthesiologyCesarean SectionFemaleHumansLikelihood FunctionsModels, TheoreticalMultivariate AnalysisOdds RatioPregnancySerotonin AntagonistsSerotonin Antagonistscomparisonevidence synthesismultivariate meta-analysisunivariate meta-analysis

Identifiers

PMID31058440
PMCPMC6771837

What OpenQuestion holds

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Registered trials

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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.