A proposed framework to guide evidence synthesis practice for meta-analysis with zero-events studies
<h3>Objective</h3><p dir="ltr">In evidence synthesis practice, researchers often face the problem of how to deal with zero-events. Inappropriately dealing with zero-events studies may lead to research waste and mislead healthcare practice. We propose a framework to guide...
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2021
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| Summary: | <h3>Objective</h3><p dir="ltr">In evidence synthesis practice, researchers often face the problem of how to deal with zero-events. Inappropriately dealing with zero-events studies may lead to research waste and mislead healthcare practice. We propose a framework to guide researchers to better deal with zero-events in meta-analysis.</p><h3>Study design and setting</h3><p dir="ltr">We used two dimensions, one with respect to the total events count across all studies in the comparative arms in a meta-analysis, and a second with respect to whether included studies have single or both arms with zero-events, to establish the framework for the classification of meta-analysis with zero-events studies. A dataset from Cochrane systematic reviews was used to evaluate the classification.</p><h3>Results</h3><p dir="ltr">The proposed framework classifies meta-analysis with zero-events studies into six subtypes. The classification matched well to the large real-world dataset. The applicability of existing methods for zero-events were then presented under each meta-analysis subtype based on this framework, with a 5-step principle to help researchers in evidence synthesis practice.</p><h3>Conclusions</h3><p dir="ltr">The proposed framework should be considered by researchers when making decisions on the selection of the synthesis methods in a meta-analysis. It also provides a reasonable basis for the development of methodological guidelines to deal with zero-events in meta-analysis.</p><h2>Other Information</h2><p dir="ltr">Published in: Journal of Clinical Epidemiology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.jclinepi.2021.02.012" target="_blank">https://dx.doi.org/10.1016/j.jclinepi.2021.02.012</a></p> |
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