Combining endpoint and change data did not affect the summary standardised mean difference in pairwise and network meta-analyses: An empirical study in depression.

Autor: Ostinelli EG; Department of Psychiatry, University of Oxford, Oxford, UK.; Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK.; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK., Efthimiou O; Department of Psychiatry, University of Oxford, Oxford, UK.; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.; Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland., Luo Y; Department of Health Promotion and Human Behaviour, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan., Miguel C; Department of Clinical Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Karyotaki E; Department of Clinical Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Cuijpers P; Department of Clinical Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; Babeș-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania., Furukawa TA; Department of Health Promotion and Human Behaviour, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan., Salanti G; Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland., Cipriani A; Department of Psychiatry, University of Oxford, Oxford, UK.; Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK.; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
Jazyk: angličtina
Zdroj: Research synthesis methods [Res Synth Methods] 2024 Sep; Vol. 15 (5), pp. 758-768. Date of Electronic Publication: 2024 May 09.
DOI: 10.1002/jrsm.1719
Abstrakt: When studies use different scales to measure continuous outcomes, standardised mean differences (SMD) are required to meta-analyse the data. However, outcomes are often reported as endpoint or change from baseline scores. Combining corresponding SMDs can be problematic and available guidance advises against this practice. We aimed to examine the impact of combining the two types of SMD in meta-analyses of depression severity. We used individual participant data on pharmacological interventions (89 studies, 27,409 participants) and internet-delivered cognitive behavioural therapy (iCBT; 61 studies, 13,687 participants) for depression to compare endpoint and change from baseline SMDs at the study level. Next, we performed pairwise (PWMA) and network meta-analyses (NMA) using endpoint SMDs, change from baseline SMDs, or a mixture of the two. Study-specific SMDs calculated from endpoint and change from baseline data were largely similar, although for iCBT interventions 25% of the studies at 3 months were associated with important differences between study-specific SMDs (median 0.01, IQR -0.10, 0.13) especially in smaller trials with baseline imbalances. However, when pooled, the differences between endpoint and change SMDs were negligible. Pooling only the more favourable of the two SMDs did not materially affect meta-analyses, resulting in differences of pooled SMDs up to 0.05 and 0.13 in the pharmacological and iCBT datasets, respectively. Our findings have implications for meta-analyses in depression, where we showed that the choice between endpoint and change scores for estimating SMDs had immaterial impact on summary meta-analytic estimates. Future studies should replicate and extend our analyses to fields other than depression.
(© 2024 The Authors. Research Synthesis Methods published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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