Network Meta-Analysis for Single-Case Design Studies: An Illustration

Meta-analysis in a digitalized world: A step-by-step primer

In recent years, much research and many data sources have become digital. Some advantages of digital or Internet-based research, compared to traditional lab research (e.g., comprehensive data collection and storage, availability of data) are ideal for an improved meta-analyses approach.In the meantime, in meta-analyses research, different types of meta-analyses have been developed to provide research syntheses with accurate quantitative estimations. Due to its rich and unique palette of corrections, we recommend to using the Schmidt and Hunter approach for meta-analyses in a digitalized world. Our primer shows in a step-by-step fashion how to conduct a high quality meta-analysis considering digital data and highlights the most obvious pitfalls (e.g., using only a bare-bones meta-analysis, no data comparison) not only in aggregation of the data, but also in the literature search and coding procedure which are essential steps in any meta-analysis. Thus, this primer of meta-analyses is especially suited for a situation where much of future research is headed to: digital research. To map Internet-based research and to reveal any research gap, we further synthesize meta-analyses on Internet-based research (15 articles containing 24 different meta-analyses, on 745 studies, with 1,601 effect sizes), resulting in the first mega meta-analysis of the field. We found a lack of individual participant data (e.g., age and nationality). Hence, we provide a primer for high-quality meta-analyses and mega meta-analyses that applies to much of coming research and also basic hands-on knowledge to conduct or judge the quality of a meta-analyses in a digitalized world.

Exploring human biology with N-of-1 clinical trials

Studies on humans that exploit contemporary data-intensive, high-throughput 'omic' assay technologies, such as genomics, transcriptomics, proteomics and metabolomics, have unequivocally revealed that humans differ greatly at the molecular level. These differences, which are compounded by each individual's distinct behavioral and environmental exposures, impact individual responses to health interventions such as diet and drugs. Questions about the best way to tailor health interventions to individuals based on their nuanced genomic, physiologic, behavioral, etc. profiles have motivated the current emphasis on 'precision' medicine. This review's purpose is to describe how the design and execution of N-of-1 (or personalized) multivariate clinical trials can advance the field. Such trials focus on individual responses to health interventions from a whole-person perspective, leverage emerging health monitoring technologies, and can be used to address the most relevant questions in the precision medicine era. This includes how to validate biomarkers that may indicate appropriate activity of an intervention as well as how to identify likely beneficial interventions for an individual. We also argue that multivariate N-of-1 and aggregated N-of-1 trials are ideal vehicles for advancing biomedical and translational science in the precision medicine era since the insights gained from them can not only shed light on how to treat or prevent diseases generally, but also provide insight into how to provide real-time care to the very individuals who are seeking attention for their health concerns in the first place.

Violin plots as visual tools in the meta-analysis of Single-Case Experimental Designs

Despite the existence of sophisticated statistical methods, systematic reviews regularly indicate that single-case experimental designs (SCEDs) are predominantly analyzed through visual tools. For the quantitative aggregation of results, different meta-analytical techniques are available, but specific visual tools for the meta-analysis of SCEDs are lacking. The present article therefore describes the use of violin plots as visual tools to represent the raw data. We first describe the underlying rationale of violin plots and their main characteristics. We then show how the violin plots can complement the statistics obtained in a quantitative meta-analysis. The main advantages of violin plots as visual tools in meta-analysis are (a) that they preserve information about the raw data from each study, (b) that they have the ability to visually represent data from different designs in one graph, and (c) that they enable the comparison of score distributions from different experimental phases from different studies.