Clinical heterogeneity in systematic reviews and health technology assessments: Synthesis of guidance documents and the literature

International Journal of Technology Assessment in Health Care

Volumn 28, Issue 1, 2012, Pages 36-43

  Gartlehner, Gerald ^a,b   West, Suzanne L ^b   Mansfield, Alyssa J ^b   Poole, Charles ^c   Tant, Elizabeth ^b   Lux, Linda J ^b   Lohr, Kathleen N ^b  

^a DANUBE UNIVERSITY KREMS   (Austria)

^b RTI INTERNATIONAL   (United States)

^c UNIVERSITY OF NORTH CAROLINA   (United States)

Author keywords

Clinical heterogeneity; Comparative effectiveness; Effect measure modification; Health technology assessment; Systematic review

Indexed keywords

CLINICAL HETEROGENEITY; COMPARATIVE EFFECTIVENESS; EFFECT MEASURE MODIFICATION; HEALTH TECHNOLOGY ASSESSMENT; SYSTEMATIC REVIEW;

ABSTRACTING; HEALTH; INTERNATIONAL COOPERATION; PATIENT TREATMENT;

HEALTH RISKS;

CLINICAL PRACTICE; HEALTH CARE QUALITY; HEALTH TECHNOLOGY ASSESSMENT; OUTCOME ASSESSMENT; REVIEW; SYSTEMATIC REVIEW (TOPIC);

BENCHMARKING; BIAS (EPIDEMIOLOGY); BIOMEDICAL TECHNOLOGY; COMPARATIVE EFFECTIVENESS RESEARCH; DECISION MAKING; HUMANS; PRACTICE GUIDELINES AS TOPIC; REVIEW LITERATURE AS TOPIC; TECHNOLOGY ASSESSMENT, BIOMEDICAL;

EID: 84859044068     PISSN: 02664623     EISSN: 14716348     Source Type: Journal    
DOI: 10.1017/S0266462311000687     Document Type: Review

References (25)

1. Agency for Healthcare Research and Quality. Methods Reference Guide for Effectiveness and Comparative Effectiveness Reviews. 2007. http:// effectivehealthcare.ahrq.gov/repFiles/2007-10DraftMethodsGuide.pdf (accessed August 31, 2010).
2. Berlin JA. Invited commentary: Benefits of heterogeneity in meta-analysis of data from epidemiologic studies. Am J Epidemiol. 1995;142:383-387.
3. Berlin JA, Santanna J, Schmid CH, Szczech LA, Feldman HI. Individual patient- versus group-level data meta-regressions for the investigation of treatment effect modifiers: Ecological bias rears its ugly head. Stat Med. 2002;21:371-387. (Pubitemid 34144648)
4. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to meta-analysis. New York: John Wiley and Sons, Ltd.; 2009.
5. Centre for Reviews and Dissemination. Centre for Reviews and Disssemination's (CRD) systematic reviews: Guidance for undertaking reviews in health care. 2008. Systematic-Reviews.pdf (accessed May 24, 2010).
6. Cochran W. The combination of estimates from different experiments. Biometrics. 1954;10:101-121.
7. Colditz GA, Burdick E, Mosteller F. Heterogeneity in meta-analysis of data from epidemiologic studies: A commentary. Am J Epidemiol. 1995;142:371-382.
8. Dias S, Welton NJ, Caldwell DM, Ades AE. Checking consistency in mixed treatment comparison meta-analysis. Stat Med. 29:932-944.
9. Drug Effectiveness Review Project. Review methods and report production procedures. 2008. evidence-based-policy-center/derp/documents/methods.cfm (accessed August 31, 2010).
10. European Network for Health Technology Assessment. HTA core model for medical and surgical interventions 1.0R. 2008. . net/upload/WP4/ Final%20Deliverables/HTA%20Core%20Model%20for %20Medical%20and%20Surgical%20Interventions%201%200r.pdf (accessed August 30, 2010).
11. Gartlehner G, Hansen RA, Thieda P, et al. Comparative effectiveness of second-generation antidepressants in the pharmacologic treatment of adult depression. Comparative Effectiveness Review No. 7. Rockville, MD: Agency for Healthcare Research and Quality. January 2007. and-reports/?pageaction= displayproduct&productid=61 (accessed November 16, 2011).
12. Greenland S, O'Rourke K. Meta-analysis. In: Rothman KJ, Greenland S, Lash TL eds. Modern Epidemiology. Philadelphia, PA: Lippincott Williams & Wilkins; 2008:652-682.
13. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539-1558. (Pubitemid 34746062)
14. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557-560. (Pubitemid 37088507)
15. Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions 5.0.2 [updated September 2009]. 2009. www.cochranehandbook . org.
16. Ioannidis JP, Patsopoulos NA, EVangelou E. Uncertainty in heterogeneity estimates in meta-analyses. BMJ. 2007;335:914-916. (Pubitemid 350076978)
17. Kennedy SH, Fulton KA, Bagby RM, et al. Sexual function during bupropion or paroxetine treatment of major depressive disorder. Can J Psychiatry. 2006;51:234-242.
18. Kravitz RL, Duan N, Braslow J. Evidence-based medicine, heterogeneity of treatment effects, and the trouble with averages. Milbank Q. 2004;82:661-687. (Pubitemid 40143102)
19. Layton D, Pearce GL, Shakir SA. Safety profile of tolterodine as used in general practice in England: Results of prescription-event monitoring. Drug Saf. 2001;24:703-713. (Pubitemid 32758569)
20. Morton SC, Adam JL, Suttorp MJ, Shekelle PG. Meta-regression approaches: What, why, when, and how? Technical Review 8 prepared by Southern California-RAND-Evidence-based Practice Center, under Contract No 290-97-0001. AHRQ Publication No 04-033, Rockville, MD: Agency for Healthcare Research and Quality, 2004.
21. Petitti DB. Approaches to heterogeneity in meta-analysis. Stat Med. 2001;20:3625-3633. (Pubitemid 33114432)
22. Poole C, Greenland S. Random-effects meta-analyses are not always conservative. Am J Epidemiol. 1999;150:469-475. (Pubitemid 29407230)
23. Shadish WR, Cook TD, Campbell DT. Experimental and quasiexperimental designs for generalized causal inference. Florence, KY: Houghton Mifflin College; 2003.
24. Thompson SG. Why sources of heterogeneity in metaanalysis should be investigated. BMJ. 1994;309:1351-1355. (Pubitemid 24345976)
25. West SL, Gartlehner G, Mansfield AJ, et al. Comparative effectiveness review methods: Clinical heterogeneity. Rockville, MD. Agency for Healthcare Research and Quality: RTI International-University of North Carolina Evidence-based Practice Center; 2010.