論文

査読有り 国際誌
2021年3月15日

Comparing methods for estimating patient-specific treatment effects in individual patient data meta-analysis.

Statistics in medicine
  • Michael Seo
  • ,
  • Ian R White
  • ,
  • Toshi A Furukawa
  • ,
  • Hissei Imai
  • ,
  • Marco Valgimigli
  • ,
  • Matthias Egger
  • ,
  • Marcel Zwahlen
  • ,
  • Orestis Efthimiou

40
6
開始ページ
1553
終了ページ
1573
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1002/sim.8859

Meta-analysis of individual patient data (IPD) is increasingly used to synthesize data from multiple trials. IPD meta-analysis offers several advantages over meta-analyzing aggregate data, including the capacity to individualize treatment recommendations. Trials usually collect information on many patient characteristics. Some of these covariates may strongly interact with treatment (and thus be associated with treatment effect modification) while others may have little effect. It is currently unclear whether a systematic approach to the selection of treatment-covariate interactions in an IPD meta-analysis can lead to better estimates of patient-specific treatment effects. We aimed to answer this question by comparing in simulations the standard approach to IPD meta-analysis (no variable selection, all treatment-covariate interactions included in the model) with six alternative methods: stepwise regression, and five regression methods that perform shrinkage on treatment-covariate interactions, that is, least absolute shrinkage and selection operator (LASSO), ridge, adaptive LASSO, Bayesian LASSO, and stochastic search variable selection. Exploring a range of scenarios, we found that shrinkage methods performed well for both continuous and dichotomous outcomes, for a variety of settings. In most scenarios, these methods gave lower mean squared error of the patient-specific treatment effect as compared with the standard approach and stepwise regression. We illustrate the application of these methods in two datasets from cardiology and psychiatry. We recommend that future IPD meta-analysis that aim to estimate patient-specific treatment effects using multiple effect modifiers should use shrinkage methods, whereas stepwise regression should be avoided.

リンク情報
DOI
https://doi.org/10.1002/sim.8859
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33368415
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7898845
ID情報
  • DOI : 10.1002/sim.8859
  • PubMed ID : 33368415
  • PubMed Central 記事ID : PMC7898845

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