A comparison of meta-analytic methods for synthesizing evidence from explanatory and pragmatic trials

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dc.contributor.authorSajobi, Tolulope T.
dc.contributor.authorLi, Guowei
dc.contributor.authorAwosoga, Olu A.
dc.contributor.authorWang, Meng
dc.contributor.authorMenon, Bijoy K.
dc.contributor.authorHill, Michael D.
dc.contributor.authorThabane, Lehana
dc.date.accessioned2019-12-19T00:19:37Z
dc.date.available2019-12-19T00:19:37Z
dc.date.issued2018
dc.descriptionSherpa Romeo green journal. Open access article. Creative Commons Attribution 4.0 International License (CC BY 4.0) appliesen_US
dc.description.abstractBackground: The pragmatic–explanatory continuum indicator summary version 2 (PRECIS-2) tool has recently been developed to classify randomized clinical trials (RCTs) as pragmatic or explanatory based on their design characteristics. Given that treatment effects in explanatory trials may be greater than those obtained in pragmatic trials, conventional meta-analytic approaches may not accurately account for the heterogeneity among the studies and may result in biased treatment effect estimates. This study investigates if the incorporation of PRECIS-2 classification of published trials can improve the estimation of overall intervention effects in meta-analysis. Methods: Using data from 31 published trials of intervention aimed at reducing obesity in children, we evaluated the utility of incorporating PRECIS-2 ratings of published trials into meta-analysis of intervention effects in clinical trials. Specifically, we compared random-effects meta-analysis, stratified meta-analysis, random-effects meta-regression, and mixture random-effects meta-regression methods for estimating overall pooled intervention effects. Results: Our analyses revealed that mixture meta-regression models that incorporate PRECIS-2 classification as covariate resulted in a larger pooled effect size (ES) estimate (ES=−1.01, 95%CI=[−1.52, −0.43]) than conventional random-effects meta-analysis (ES=−0.15, 95%CI=[−0.23, −0.08]). Conclusions: In addition to the original intent of PRECIS-2 tool of aiding researchers in their choice of trial design, PRECIS2 tool is useful for explaining between study variations in systematic review and meta-analysis of published trials. We recommend that researchers adopt mixture meta-regression methods when synthesizing evidence from explanatory and pragmatic trials.en_US
dc.description.peer-reviewYesen_US
dc.identifier.citationSajobi, T. T., Li, G., Awosoga, O., Wang, M., Menon, B. K., Hill, M. D., & Thabane, L. (2018). A comparison of meta-analytic methods for synthesizing evidence from explanatory and pragmatic trials. Systematic Reviews, 7, 19. doi:10.1186/s13643-017-0668-3en_US
dc.identifier.urihttps://hdl.handle.net/10133/5641
dc.language.isoen_USen_US
dc.publisherBioMed Centralen_US
dc.publisher.facultyHealth Sciencesen_US
dc.publisher.institutionUniversity of Calgaryen_US
dc.publisher.institutionMcMaster Universityen_US
dc.publisher.institutionUniversity of Lethbridgeen_US
dc.publisher.institutionResearch Institute at St Joseph's Healthcareen_US
dc.publisher.urlhttps://doi.org/10.1186/s13643-017-0668-3en_US
dc.subjectMeta-analysisen_US
dc.subjectPRECIS-2en_US
dc.subjectObesity interventionsen_US
dc.subjectRandomized controlled trialsen_US
dc.subjectSystematic reviewen_US
dc.titleA comparison of meta-analytic methods for synthesizing evidence from explanatory and pragmatic trialsen_US
dc.typeArticleen_US
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