jueves, 14 de abril de 2016

Change Score or Followup Score? Choice of Mean Difference Estimates Could Impact Meta-analysis Conclusions. - PubMed - NCBI

2016 Feb 27. pii: S0895-4356(16)00152-9. doi: 10.1016/j.jclinepi.2016.01.034. [Epub ahead of print]

Change Score or Followup Score? Choice of Mean Difference Estimates Could Impact Meta-analysis Conclusions.

Author information

Abstract

OBJECTIVE:

In randomized controlled clinical trials, continuous outcomes are typically measured at both baseline and followup, and mean difference could be estimated using the change scores from baseline, or the followup scores. This study assesses the impact of using change score versus followup score on the conclusions of meta-analyses.

STUDY DESIGN AND SETTING:

A total of 63 meta-analyses from 6 comparative effectiveness reviews were included. The combined mean difference was estimated using a random effects model and we also evaluated whether the impact qualitatively varied by alternative random effects estimates.

RESULTS:

Based on the Dersimonian-Laird (DL) method, using the change versus the followup score led to 5 meta-analyses (7.9%) showing discrepancy in conclusions. Based on the profile likelihood (PL) method, 9 (14.3%) showed discrepancy in conclusions. Using change score was more likely to show a significant difference in effects between interventions (DL method: 4 out of 5; PL method: 7 out of 9). A significant difference in baseline scores did not necessarily lead to discrepancies in conclusions.

CONCLUSIONS:

Using the change versus the followup score could lead to important discrepancies in conclusions. Sensitivity analyses should be conducted to check the robustness of results to the choice of mean difference estimates.