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Abstract:
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Meta-analysis techniques, if applied appropriately, can provide a summary of the totality of evidence regarding an overall difference between a new treatment and a control group using data from multiple comparative clinical studies. The standard meta-analysis procedures, however, may not give a meaningful between-group difference summary measure or identify a meaningful patient population of interest, especially when the fixed-effect model assumption is not met. Moreover, a single between-group comparison measure without a reference value obtained from patients in the control arm would likely not be informative enough for clinical decision making. In this paper, we propose a simple, robust procedure based on a mixture population concept and provide a clinically meaningful group contrast summary for a well-defined target population. We use the data from a recent meta-analysis for evaluating statin therapies with respect to the incidence of fatal stroke events to illustrate the issues associated with the standard meta-analysis procedures as well as the advantages of our simple proposal.
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