Prospective meta-analysis using individual patient data in intensive care medicine.
Meta-analysis is a technique for combining evidence from multiple trials. However, meta-analyses of studies with substantial heterogeneity among patients within trials-common in intensive care-can lead to incorrect conclusions if performed using aggregate data. Use of individual patient data (IPD) can avoid this concern, increase the power of a meta-analysis, and is useful for exploring subgroup effects. Barriers exist to IPD meta-analysis, most of which are overcome if clinical trials are designed to prospectively facilitate the incorporation of their results with other trials. We review the features of prospective IPD meta-analysis and identify those of relevance to intensive care research. We identify three clinical questions, which are the subject of recent or planned randomised controlled trials where IPD MA offers advantages over approaches using aggregate data.
Reade
Michael C
MC
CRISMA Laboratory, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA. michael.reade@austin.org.au
Delaney
Anthony
A
Bailey
Michael J
MJ
Harrison
David A
DA
Yealy
Donald M
DM
Jones
Peter G
PG
Rowan
Kathryn M
KM
Bellomo
Rinaldo
R
Angus
Derek C
DC
D003422:Critical Care / Q000706:statistics & numerical data*; D003627:Data Interpretation, Statistical; D006801:Humans; D008499:Medical Records; D015201:Meta-Analysis as Topic; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010361:Patients; D011446:Prospective Studies