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Re: st: Meta-analysis

From   "Tom Trikalinos" <>
Subject   Re: st: Meta-analysis
Date   Mon, 17 Mar 2008 13:24:19 -0400

this is a big topic.
see for example:

Stat Med. 2007 Jan 15;26(1):53-77. Much ado about nothing: a
comparison of the performance of meta-analytical methods with rare
events.   Bradburn MJ, Deeks JJ, Berlin JA, Russell Localio A.

Stat Med. 2004 May 15;23(9):1351-75. What to add to nothing? Use and
avoidance of continuity corrections in meta-analysis of sparse data.
Sweeting MJ, Sutton AJ, Lambert PC.

and quite a few other papers that are out there.  The ones discussing
the recent rosiglitazone meta-analysis are also relevant. Do a PubMed
search if you have not already.

My take: Assuming you do not go Bayesian and that you use the typical
garden variety meta-analysis methods:

1. Random effects per Der Simonian and Laird are probably a no for
main analyses (biased tau^2 in simulation studies).
2. Peto OR seems to do well in terms of bias and coverage
probabilities for the CI (!).
3. Mantel-Haenszel (MH) OR seems to do well, I presume the same for RR
though i think this is not as clear, or so i remember.
4. M-H RD is reported to give somehow biased estimates and conservative CI

5. If you use multiplicative effect sizes - e.g. an OR I would
calculate main analyses without 0% vs 0% studies, then add them in in
a sensitivity analysis

All the above allowing for the caveat that one an operational
knowledge of the relevant methods literature and knowledge of which
methods need fudge factors to correct for 0 cells...

hope this helps


On Mon, Mar 17, 2008 at 12:42 PM, Sripal Kumar <> wrote:
> I was wondering what are your thoughts on meta analysis of trials with
>  limited number of events.  Should studies with no events be censored
>  from the analysis?
>  Any input is highly appreciated.
>  thanks,
>  Sripal.
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