Please use this identifier to cite or link to this item:
http://hdl.handle.net/1942/26364
Title: | Combining evidence from multiple electronic health care databases: performances of one-stage and two-stage meta-analysis in matched case-control studies | Authors: | LA GAMBA, Fabiola Corrao, Giovanni Romio, Silvana Sturkenboom, Miriam Trifiro, Gianluca Schink, Tania de Ridder, Maria |
Issue Date: | 2017 | Publisher: | WILEY | Source: | PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, 26(10), p. 1213-1219 | Abstract: | PurposeClustering of patients in databases is usually ignored in one-stage meta-analysis of multi-database studies using matched case-control data. The aim of this study was to compare bias and efficiency of such a one-stage meta-analysis with a two-stage meta-analysis. MethodsFirst, we compared the approaches by generating matched case-control data under 5 simulated scenarios, built by varying: (1) the exposure-outcome association; (2) its variability among databases; (3) the confounding strength of one covariate on this association; (4) its variability; and (5) the (heterogeneous) confounding strength of two covariates. Second, we made the same comparison using empirical data from the ARITMO project, a multiple database study investigating the risk of ventricular arrhythmia following the use of medications with arrhythmogenic potential. In our study, we specifically investigated the effect of current use of promethazine. ResultsBias increased for one-stage meta-analysis with increasing (1) between-database variance of exposure effect and (2) heterogeneous confounding generated by two covariates. The efficiency of one-stage meta-analysis was slightly lower than that of two-stage meta-analysis for the majority of investigated scenarios. Based on ARITMO data, there were no evident differences between one-stage (OR=1.50, CI=[1.08; 2.08]) and two-stage (OR=1.55, CI=[1.12; 2.16]) approaches. ConclusionsWhen the effect of interest is heterogeneous, a one-stage meta-analysis ignoring clustering gives biased estimates. Two-stage meta-analysis generates estimates at least as accurate and precise as one-stage meta-analysis. However, in a study using small databases and rare exposures and/or outcomes, a correct one-stage meta-analysis becomes essential. | Notes: | [La Gamba, Fabiola] Janssen Pharmaceut NV, Turnhoutseweg 30, B-2340 Beerse, Belgium. [La Gamba, Fabiola] Interuniv Inst Biostat & Stat Bioinformat, Ctr Stat, Campus Diepenbeek, Diepenbeek, Belgium. [Corrao, Giovanni; Romio, Silvana] Univ Milano Bicocca, Unit Biostat Epidemiol & Publ Hlth, Dept Stat & Quantitat Methods, Milan, Italy. [Corrao, Giovanni; Romio, Silvana] Univ Milano Bicocca, Ctr Publ Hlth, Milan, Italy. [Romio, Silvana; Sturkenboom, Miriam; Trifiro, Gianluca; de Ridder, Maria] Erasmus Univ, Dept Med Informat, Sch Med, Rotterdam, Netherlands. [Trifiro, Gianluca] Univ Messina, Dept Biomed & Dent Sci & Morphofunct Imaging, Messina, Italy. [Schink, Tania] Leibniz Inst Prevent Res & Epidemiol, Dept Clin Epidemiol, Bremen, Germany. | Keywords: | electronic health records; matched case-control study; meta-analysis; multicenter study; one-stage; two-stage;electronic health records; matched case-control study; meta-analysis; multicenter study; one-stage; two-stage | Document URI: | http://hdl.handle.net/1942/26364 | ISSN: | 1053-8569 | e-ISSN: | 1099-1557 | DOI: | 10.1002/pds.4280 | ISI #: | 000412105600010 | Rights: | Copyright © 2017 John Wiley & Sons, Ltd. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2018 |
Appears in Collections: | Research publications |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
Gamba_et_al-2017-Pharmacoepidemiology_and_Drug_Safety.pdf Restricted Access | Published version | 217.05 kB | Adobe PDF | View/Open Request a copy |
SCOPUSTM
Citations
2
checked on Sep 3, 2020
WEB OF SCIENCETM
Citations
7
checked on Oct 4, 2024
Page view(s)
66
checked on Sep 7, 2022
Download(s)
60
checked on Sep 7, 2022
Google ScholarTM
Check
Altmetric
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.