title: Meta-analysis of data on costs from trials of counselling in primary care: using individual patient data to overcome sample size limitations in economic analyses.
abstract: OBJECTIVE
  To assess the feasibility of overcoming sample size limitations in economic analyses of clinical trials through meta-analysis of data on individual patients from multiple trials.
  
  
  METHODS
  Meta-analysis of individual patient data from trials of counselling in primary care compared with usual care by a general practitioner.
  
  
  METHODS
  Primary care.
  
  
  METHODS
  People with mental health problems.
  
  
  METHODS
  Direct treatment costs, depressive symptoms, and cost effectiveness.
  
  
  RESULTS
  Meta-analysis of individual patient data proved feasible. The results showed that the previous analyses of individual trials were underpowered to provide useful conclusions about the cost comparisons. The results are sensitive to assumptions made about the costs of sessions with a counsellor and the management of patients by a general practitioner.
  
  
  CONCLUSIONS
  Meta-analysis of individual patient data may assist in overcoming sample size limitations in economic analyses. Although feasible, such analysis has shortcomings that may limit the validity of the results. The relative costs and benefits of this method, as opposed to further collection of primary data, are as yet unclear.
authors.affiliation: National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL. peter.bower@man.ac.uk
authors.forename: Peter
authors.initials: P
authors.lastname: Bower
authors.forename: Sarah
authors.initials: S
authors.lastname: Byford
authors.forename: Julie
authors.initials: J
authors.lastname: Barber
authors.forename: Jennifer
authors.initials: J
authors.lastname: Beecham
authors.forename: Sharon
authors.initials: S
authors.lastname: Simpson
authors.forename: Karin
authors.initials: K
authors.lastname: Friedli
authors.forename: Roslyn
authors.initials: R
authors.lastname: Corney
authors.forename: Michael
authors.initials: M
authors.lastname: King
authors.forename: Ian
authors.initials: I
authors.lastname: Harvey
mesh_terms: D002986:Clinical Trials as Topic / Q000191:economics*; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003376:Counseling / Q000191:economics*; D005194:Family Practice / Q000191:economics; D005240:Feasibility Studies; D006801:Humans; D011320:Primary Health Care / Q000191:economics*; D018401:Sample Size; D012680:Sensitivity and Specificity