To expedite the timely creation of medical practice guidelines, a meta-analytic method was developed to combine of both dichotomous survival data and continuous physiologic data from multiple studies comparing the same innovative clinical intervention to standard care. The method is adapted for synthesis of small, early studies of novel treatments. An aggregate ratio, R*, of the observed treatment effect to a clinically optimal treatment effect for studies in a series is computed, and compared to the 95% confidence limit for R* under the null hypothesis. Weights assigned to each study may reflect its precision, quality, or clinical relevance. Input data for continuous variables include sample means, standard errors, and sample sizes. Input data for dichotomous variables include group proportions and sizes. The analysis can be done using a simple, one-page spreadsheet. It allows one to judge biological significance, to test for statistical significance, to compare subgroups of studies for differences (heterogeneity of effect), to test for outliers, and to compute the power of the meta-analysis. These features are demonstrated for studies of interposed abdominal compression—cardiopulmonary resuscitation (IAC-CPR). This novel method of meta-analysis can provide rapid, quantitative, and accurate estimates of the amount of benefit or harm from an experimental clinical intervention, as reported in multiple small independent studies of differing experimental design.
abdominal, cardiopulmonary resuscitation, confidence intervals, continuous, data interpretation, evidence-based medicine, interposed abdominal compression (IAC)-CPR, orphan drugs, pediatric research
Date of this Version
Babbs, Charles F., "Meta-analysis of Two-Treatment Clinical Trials Including Both Continuous and Dichotomous Results" (2004). Weldon School of Biomedical Engineering Faculty Publications. Paper 61.