Evidence map›Paper›PMID 37365521›Full record

SynthesisBMC medical research methodology2023

Calibrated meta-analysis to estimate the efficacy of mental health treatments in target populations: an application to paliperidone trials for treatment of schizophrenia.

Hwanhee Hong, Lu Liu, Ramin Mojtabai, Elizabeth A Stuart

Abstract readMeta-Analysis
In one paragraph

Synthesis in BMC medical research methodology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
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.

Hwanhee HongDepartment of Biostatistics and Bioinformatics, School of Medicine, Duke University, 2424 Erwin Road, Ste 1105, Durham, NC, 27705, USA. hwanhee.hong@duke.edu.
Lu LiuDepartment of Biostatistics and Bioinformatics, School of Medicine, Duke University, 2424 Erwin Road, Ste 1105, Durham, NC, 27705, USA.
Ramin MojtabaiDepartment of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
Elizabeth A StuartDepartment of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.

Funding

Combining data sources to identify effect moderation for personalized mental health treatmentR01MH126856 · NIMH · JOHNS HOPKINS UNIVERSITY · PI STUART, ELIZABETH A. · 2021 to 2024
$1.7M
Estimating Population Effects in Mental Health Research Using Meta-AnalysisR00MH111807 · NIMH · DUKE UNIVERSITY · PI HONG, HWANHEE · 2018 to 2020
$747k
NIMH NIH HHS R00MH111807NIMH NIH HHS R01MH126856
6 · The paper itself

Abstract

backgroundsMeta-analyses can be a powerful tool but need to calibrate potential unrepresentativeness of the included trials to a target population. Estimating target population average treatment effects (TATE) in meta-analyses is important to understand how treatments perform in well-defined target populations. This study estimated TATE of paliperidone palmitate in patients with schizophrenia using meta-analysis with individual patient trial data and target population data.

methodsWe conducted a meta-analysis with data from four randomized clinical trials and target population data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study. Efficacy was measured using the Positive and Negative Syndrome Scale (PANSS). Weights to equate the trial participants and target population were calculated by comparing baseline characteristics between the trials and CATIE. A calibrated weighted meta-analysis with random effects was performed to estimate the TATE of paliperidone compared to placebo.

resultsA total of 1,738 patients were included in the meta-analysis along with 1,458 patients in CATIE. After weighting, the covariate distributions of the trial participants and target population were similar. Compared to placebo, paliperidone palmitate was associated with a significant reduction of the PANSS total score under both unweighted (mean difference 9.07 [4.43, 13.71]) and calibrated weighted (mean difference 6.15 [2.22, 10.08]) meta-analysis.

conclusionsThe effect of paliperidone palmitate compared with placebo is slightly smaller in the target population than that estimated directly from the unweighted meta-analysis. Representativeness of samples of trials included in a meta-analysis to a target population should be assessed and incorporated properly to obtain the most reliable evidence of treatment effects in target populations.

Indexed as

Antipsychotic AgentsSchizophreniaHumansIsoxazolesMental HealthPaliperidone PalmitateRandomized Controlled Trials as TopicAntipsychotic AgentsIsoxazolesPaliperidone PalmitateGeneralizabilityIndividual-Level DataMeta-AnalysisPaliperidone PalmitateRandomized trialsSchizophreniaTarget Population

Identifiers

PMID37365521
PMCPMC10294408

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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.