Meta-analysis of continuous outcomes: Using pseudo IPD created from aggregate data to adjust for baseline imbalance and assess treatment-by-baseline modification

Res Synth Methods. 2020 Nov;11(6):780-794. doi: 10.1002/jrsm.1434. Epub 2020 Jul 25.

Abstract

Meta-analysis of individual participant data (IPD) is considered the "gold-standard" for synthesizing clinical study evidence. However, gaining access to IPD can be a laborious task (if possible at all) and in practice only summary (aggregate) data are commonly available. In this work we focus on meta-analytic approaches of comparative studies where aggregate data are available for continuous outcomes measured at baseline (pre-treatment) and follow-up (post-treatment). We propose a method for constructing pseudo individual baselines and outcomes based on the aggregate data. These pseudo IPD can be subsequently analysed using standard analysis of covariance (ANCOVA) methods. Pseudo IPD for continuous outcomes reported at two timepoints can be generated using the sufficient statistics of an ANCOVA model, i.e., the mean and standard deviation at baseline and follow-up per group, together with the correlation of the baseline and follow-up measurements. Applying the ANCOVA approach, which crucially adjusts for baseline imbalances and accounts for the correlation between baseline and change scores, to the pseudo IPD, results in identical estimates to the ones obtained by an ANCOVA on the true IPD. In addition, an interaction term between baseline and treatment effect can be added. There are several modeling options available under this approach, which makes it very flexible. Methods are exemplified using reported data of a previously published IPD meta-analysis of 10 trials investigating the effect of antihypertensive treatments on systolic blood pressure, leading to identical results compared with the true IPD analysis and of a meta-analysis of fewer trials, where baseline imbalance occurred.

Keywords: ANCOVA; meta-analysis; pseudo individual participant data; sufficient statistics.

Publication types

  • Meta-Analysis

MeSH terms

  • Algorithms
  • Analysis of Variance
  • Blood Pressure Determination
  • Clinical Trials as Topic
  • Computer Simulation
  • Data Interpretation, Statistical*
  • Humans
  • Hypertension / physiopathology
  • Hypertension / therapy*
  • Models, Statistical
  • Outcome Assessment, Health Care / methods
  • Research Design*
  • Sleep Apnea, Obstructive / physiopathology
  • Sleep Apnea, Obstructive / therapy*
  • Systole
  • Treatment Outcome