Fall-prevention programs for the elderly: a Bayesian secondary meta-analysis.
A secondary meta-analysis of programs to reduce falls in the elderly is undertaken to demonstrate a Bayesian analysis. The Bayesian statistical tradition is carefully distinguished from the standard Neyman-Pearson-Wald (NPW) statistical tradition. In the 12 studies, the logit effect size is used to compare treatment groups using a prevention program to control groups without a program. To contrast the Bayesian analysis, independent-effects and fixed-effect meta-analyses are first conducted in the NPW tradition. This is followed by Bayesian independent-effects and fixed-effect meta-analyses that numerically replicate the NPW results but have conceptually different interpretations. The final analyses comprise Bayesian random-effects and predictive meta-analyses. These results differ numerically from all the previous meta-analyses and conceptually from the NPW meta-analyses. The random-effects analysis allows for heterogeneity in the effect sizes. The predictive analysis yields the distribution of a new, out-of-sample effect size, which accommodates not only the heterogeneity of the effects but also the imprecision in the parameter estimates. This last analysis shows that the effectiveness of new fall-prevention programs is less definitive than that found in the sample. Bayesian statistical methods are particularly well-suited for the complexities of nursing science studies.
Lucke
Joseph E
JE
School of Nursing, University of Texas Health Science Center, San Antonio, USA.
D000058:Accidental Falls / Q000401:mortality / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D001499:Bayes Theorem; D003627:Data Interpretation, Statistical; D005851:Geriatric Nursing / Q000458:organization & administration; D006801:Humans; D016015:Logistic Models; D015399:Nursing Research / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D015397:Program Evaluation; D017751:Safety Management / Q000458:organization & administration*