title: Flexible meta-regression functions for modeling aggregate dose-response data, with an application to alcohol and mortality.
abstract: In this paper, the authors describe fractional polynomials and cubic splines with which to represent smooth dose-response relations in summarizing meta-analytical aggregate data. Use of these two curve-fitting families can help prevent the problems arising from inappropriate linearity assumptions. These methods are illustrated in the problem of estimating the shape of the dose-response curve between alcohol consumption and all-cause mortality risk. The authors considered aggregate data from 29 cohort studies investigating this issue (1966-2000). J-shaped curves with a nadir at approximately 5-7 g/day of alcohol consumption and a last protective dose of 47-60 g/day were consistently obtained from fractional polynomials and cubic splines. The authors conclude that both of the curve-fitting families are useful tools with which to explore dose-response epidemiologic questions by means of meta-analytical approaches, especially when important nonlinearity is anticipated.
authors.affiliation: Department of Statistics, University of Milan-Bicocca, Milan, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bagnardi
authors.forename: Antonella
authors.initials: A
authors.lastname: Zambon
authors.forename: Piero
authors.initials: P
authors.lastname: Quatto
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corrao
mesh_terms: D000428:Alcohol Drinking / Q000401:mortality*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D015233:Models, Statistical; D012044:Regression Analysis