Inconsistent results in meta-analyses for the prevention of falls are found between study-level data and patient-level data

Haines, Terry P. and Hill, Anne-Marie (2011) Inconsistent results in meta-analyses for the prevention of falls are found between study-level data and patient-level data. Journal of Clinical Epidemiology, 64 2: 154-162. doi:10.1016/j.jclinepi.2010.04.024


Author Haines, Terry P.
Hill, Anne-Marie
Title Inconsistent results in meta-analyses for the prevention of falls are found between study-level data and patient-level data
Journal name Journal of Clinical Epidemiology   Check publisher's open access policy
ISSN 0895-4356
1878-5921
Publication date 2011-02-01
Sub-type Article (original research)
DOI 10.1016/j.jclinepi.2010.04.024
Open Access Status Not Open Access
Volume 64
Issue 2
Start page 154
End page 162
Total pages 9
Place of publication Philadelphia, United States
Publisher Elsevier
Language eng
Formatted abstract
Objective
This study seeks to examine whether existing study-level data meta-analysis approaches can be used to produce unbiased and precise effect estimates relative to meta-analyses conducted using patient-level data, where a recurrent event is the outcome of interest.

Study Design and Setting
Data from two studies focusing on the prevention of falls in the hospital setting (N = 1,838 total) was divided into the three hospital sites from which data were collected. Outcome data were considered as recurrent event survival data, single event survival data, count data, rate data, and binary data. A range of analysis approaches were considered.

Results
Andersen–Gill, negative binomial, bootstrap resampling, and modified relative risk analysis approaches produced congruous point estimates of effect, whereas modified relative risk analysis produced considerably smaller standard errors. Pooled effect point estimates derived from these approaches were not consistent when using study-level data as opposed to patient-level data, and 95% confidence intervals were excessively wide when between-study heterogeneity was present.

Conclusion
Conducting meta-analysis using patient-level data (if possible) or presenting results from individual trials without pooling of effect estimates may be preferable to presenting pooled effect estimates from meta-analysis of study-level data, where the outcome is a recurrent event.
Keyword Accidental falls
Hospitals
Meta-analysis
Statistical analysis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Health and Rehabilitation Sciences Publications
 
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