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Review

Conducting Quantitative Synthesis When Comparing Medical Interventions: AHRQ and the Effective Health Care Program

Rongwei Fu  1 , Gerald Gartlehner  2 , Mark Grant  3 , Tatyana Shamliyan  4 , Art Sedrakyan  5 , Timothy J Wilt  6 , Lauren Griffith  7 , Mark Oremus  7 , Parminder Raina  7 , Afisi Ismaila  7 , Pasqualina Santaguida  7 , Joseph Lau  8 , Thomas A Trikalinos  8
In: Methods Guide for Effectiveness and Comparative Effectiveness Reviews [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008.
AHRQ Methods for Effective Health Care.
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Review

Conducting Quantitative Synthesis When Comparing Medical Interventions: AHRQ and the Effective Health Care Program

Rongwei Fu et al.
Free Books & Documents

Excerpt

Objective: The objective is to establish recommendations for conducting quantitative synthesis or meta-analysis using study-level data in Comparative effectiveness reviews (CERs) for the Evidence-based Practice Center (EPC) program of the Agency for Healthcare Research and Quality (AHRQ).

Study Design and Setting: We focused on recurrent issues in the EPC program and the recommendations were developed using group discussion and consensus based on current knowledge in the literature.

Results: We first discussed considerations for deciding whether to combine studies, followed by discussions on indirect comparison and incorporation of indirect evidence. Then we described our recommendations on choosing effect measures and statistical models, giving special attention to combining studies with rare events, and on testing and exploring heterogeneity. Finally, we briefly present recommendations on combining studies of mixed design and on sensitivity analysis.

Conclusion: Quantitative synthesis should be conducted in a transparent and consistent way. Inclusion of multiple alternative interventions in CERs increases the complexity of quantitative synthesis while the basic issues in quantitative synthesis remain crucial considerations in quantitative synthesis for a CER. We will cover more issues in future versions and update and improve recommendations with the accumulation of new research to advance the goal for transparency and consistency.

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