Lehert P. Towards better meta-analyses in assisted reproductive technology: Fixed, random or multivariate models?
World J Meta-Anal 2015;
3:225-231. [DOI:
10.13105/wjma.v3.i6.225]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 08/13/2015] [Accepted: 10/19/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To study the validity of the fixed, random, and multivariate meta-analytical models applied in meta-analyses in artificial reproduction technique.
METHODS: Based on common characteristics of in vitro fertilization (IVF) meta-analyses, we simulated a large number of data to compare results issued from the fixed model (FM) with the random model (RM). For multiple endpoints meta-analysis (MA), we compared the univariate RM with the multivariate model (MM). Finally, we illustrate our findings in re-analyzing a recent MA.
RESULTS: In our review, although a homogeneous effect was excluded in 89% of the MAs (11%), FM was utilized in 41 studies (82%). From simulations, a concordance of 59% ± 6% was found between the two tests, with up to 65% of falsely significant results with FM. The Q-test on studies characterized by substantial heterogeneity falsely accepted homogeneity in 46% of studies. Comparing separate univariate RM and MM on multiple endpoints studies, MM reduces the between endpoint discrepancy (BED) of 68%, and increases the power of 57% ± 8%. In the example dealing with the controversial effect of luteneizing hormone supplementation to follicle stimulating hormone during ovarian stimulation in IVF cycles, MM reduced BED by 66%, and consistent effects were found for all the endpoints, irrespective of partial reporting.
CONCLUSION: The FM generally may produce falsely significant differences. The RM should always be used. For multiple endpoints, the MM constitutes the best option.
Collapse