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Impact of analysing continuous outcomes using final values, change scores and analysis of covariance on the performance of meta-analytic methods: a simulation study.

ABSTRACT: When meta-analysing intervention effects calculated from continuous outcomes, meta-analysts often encounter few trials, with potentially a small number of participants, and a variety of trial analytical methods. It is important to know how these factors affect the performance of inverse-variance fixed and DerSimonian and Laird random effects meta-analytical methods. We examined this performance using a simulation study. Meta-analysing estimates of intervention effect from final values, change scores, ANCOVA or a random mix of the three yielded unbiased estimates of pooled intervention effect. The impact of trial analytical method on the meta-analytic performance measures was important when there was no or little heterogeneity, but was of little relevance as heterogeneity increased. On the basis of larger than nominal type I error rates and poor coverage, the inverse-variance fixed effect method should not be used when there are few small trials. When there are few small trials, random effects meta-analysis is preferable to fixed effect meta-analysis. Meta-analytic estimates need to be cautiously interpreted; type I error rates will be larger than nominal, and confidence intervals will be too narrow. Use of trial analytical methods that are more efficient in these circumstances may have the unintended consequence of further exacerbating these issues. © 2015 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd. © 2015 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd.

SUBMITTER: McKenzie JE

PROVIDER: S-EPMC5217094 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:In individually randomised trials we might expect interventions delivered in groups or by care providers to result in clustering of outcomes for participants treated in the same group or by the same care provider. In partially nested randomised controlled trials (pnRCTs) this clustering only occurs in one trial arm, commonly the intervention arm. It is important to measure and account for between-cluster variability in trial design and analysis. We compare analysis approaches for pnRCTs with continuous outcomes, investigating the impact on statistical inference of cluster sizes, coding of the non-clustered arm, intracluster correlation coefficient (ICCs), and differential variance between intervention and control arm, and provide recommendations for analysis. METHODS:We performed a simulation study assessing the performance of six analysis approaches for a two-arm pnRCT with a continuous outcome. These include: linear regression model; fully clustered mixed-effects model with singleton clusters in control arm; fully clustered mixed-effects model with one large cluster in control arm; fully clustered mixed-effects model with pseudo clusters in control arm; partially nested homoscedastic mixed effects model, and partially nested heteroscedastic mixed effects model. We varied the cluster size, number of clusters, ICC, and individual variance between the two trial arms. RESULTS:All models provided unbiased intervention effect estimates. In the partially nested mixed-effects models, methods for classifying the non-clustered control arm had negligible impact. Failure to account for even small ICCs resulted in inflated Type I error rates and over-coverage of confidence intervals. Fully clustered mixed effects models provided poor control of the Type I error rates and biased ICC estimates. The heteroscedastic partially nested mixed-effects model maintained relatively good control of Type I error rates, unbiased ICC estimation, and did not noticeably reduce power even with homoscedastic individual variances across arms. CONCLUSIONS:In general, we recommend the use of a heteroscedastic partially nested mixed-effects model, which models the clustering in only one arm, for continuous outcomes similar to those generated under the scenarios of our simulations study. However, with few clusters (3-6), small cluster sizes (5-10), and small ICC (?0.05) this model underestimates Type I error rates and there is no optimal model.

Project description:BackgroundThe covariance matrix of breeding values is at the heart of prediction methods. Prediction of breeding values can be formulated using either an "observed" or a theoretical covariance matrix, and a major argument for choosing one or the other is the reduction of the computational burden for inverting such a matrix. In this regard, covariance matrices that are derived from Markov causal models possess properties that deliver sparse inverses.ResultsBy using causal Markov models, we express the breeding value of an individual as a linear regression on ancestral breeding values, plus a residual term, which we call residual breeding value (RBV). The latter is a noise term that accounts for the uncertainty in prediction due to lack of fit of the linear regression. A notable property of these models is the parental Markov condition, through which the multivariate distribution of breeding values is uniquely determined by the distribution of the mutually independent RBV. Animal breeders have long been relying on a causal Markov model, while using the additive relationship matrix as the covariance matrix structure of breeding values, which is calculated assuming gametic equilibrium. However, additional covariances among breeding values arise due to identity disequilibrium, which is defined as the difference between the covariance matrix under the multi-loci probability of identity-by-descent ([Formula: see text]) and its expectation under gametic phase equilibrium, i.e., A. The disequilibrium term [Formula: see text]-A is considered in the model for predicting breeding values called the "ancestral regression" (AR), a causal Markov model. Here, we introduce the "ancestral regression to parents" (PAR) causal Markov model, which reduces the computational burden of the AR approach. By taking advantage of the conditional independence property of the PAR Markov model, we derive covariances between the breeding values of grandparents and grand-offspring and between parents and offspring. In addition, we obtain analytical expressions for the covariance between collateral relatives under the PAR model, as well as for the inbreeding coefficient.ConclusionsWe introduced the causal PAR Markov model that captures identity disequilibrium in the covariances among breeding values and produces a sparse inverse covariance matrix to build and solve a set of mixed model equations.

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Impact of analysing continuous outcomes using final values, change scores and analysis of covariance on the performance of meta-analytic methods: a simulation study.

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