Abstract
Objective: We compared the performance of aggregate data (AD)-based and individual patient data (IPD)-based meta-analyses to synthesize evidence on the ability of D-dimer to distinguish recurrence risk in patients with unprovoked venous thromboembolism (VTE) who stopped anticoagulation. Study Design and Setting: We compared the results of the published AD-based rate ratio of VTE recurrence for positive vs. negative D-dimer, estimated by a mixed-effect Poisson model, with those of the IPD-based hazard ratio obtained by a Cox regression stratified by trial. We performed three additional analyses to investigate the methodological reasons for differences between the two approaches, comparing the IPD Cox regression with AD generated from IPD Poisson regression (to control for differences in population on study), AD time-to-event meta-analysis, and AD generated from IPD meta-regression. Results: Published analyses agreed in direction and statistical significance when estimating the prognostic value of D-dimer even if IPD estimates suggested a stronger effect. The additional analyses suggested that differences in study populations might explain this slight difference. Poor reporting in published studies precluded a true comparison of AD- and IPD-based assessments of heterogeneity sources. Conclusion: AD and IPD meta-analyses yielded similar estimates of D-dimer effect to distinguish risk for recurrent VTE. The IPD approach was justified by the need to investigate sources of heterogeneity.
| Original language | English |
|---|---|
| Pages (from-to) | 415-425 |
| Number of pages | 11 |
| Journal | Journal of Clinical Epidemiology |
| Volume | 66 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 2013 |
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Keywords
- D-dimer
- Individual patient data
- Meta-analysis
- Prognosis
- Sources of heterogeneity
- Time to event
ASJC Scopus subject areas
- Epidemiology
Cite this
Patient-level compared with study-level meta-analyses demonstrate consistency of D-dimer as predictor of venous thromboembolic recurrences. / Marcucci, Maura; Smith, Catrin Tudur; Douketis, James D.; Tosetto, Alberto; Baglin, Trevor; Cushman, Mary; Eichinger, Sabine; Palareti, Gualtiero; Poli, Daniela; Tait, Robert Campbell; Iorio, Alfonso.
In: Journal of Clinical Epidemiology, Vol. 66, No. 4, 04.2013, p. 415-425.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Patient-level compared with study-level meta-analyses demonstrate consistency of D-dimer as predictor of venous thromboembolic recurrences
AU - Marcucci, Maura
AU - Smith, Catrin Tudur
AU - Douketis, James D.
AU - Tosetto, Alberto
AU - Baglin, Trevor
AU - Cushman, Mary
AU - Eichinger, Sabine
AU - Palareti, Gualtiero
AU - Poli, Daniela
AU - Tait, Robert Campbell
AU - Iorio, Alfonso
PY - 2013/4
Y1 - 2013/4
N2 - Objective: We compared the performance of aggregate data (AD)-based and individual patient data (IPD)-based meta-analyses to synthesize evidence on the ability of D-dimer to distinguish recurrence risk in patients with unprovoked venous thromboembolism (VTE) who stopped anticoagulation. Study Design and Setting: We compared the results of the published AD-based rate ratio of VTE recurrence for positive vs. negative D-dimer, estimated by a mixed-effect Poisson model, with those of the IPD-based hazard ratio obtained by a Cox regression stratified by trial. We performed three additional analyses to investigate the methodological reasons for differences between the two approaches, comparing the IPD Cox regression with AD generated from IPD Poisson regression (to control for differences in population on study), AD time-to-event meta-analysis, and AD generated from IPD meta-regression. Results: Published analyses agreed in direction and statistical significance when estimating the prognostic value of D-dimer even if IPD estimates suggested a stronger effect. The additional analyses suggested that differences in study populations might explain this slight difference. Poor reporting in published studies precluded a true comparison of AD- and IPD-based assessments of heterogeneity sources. Conclusion: AD and IPD meta-analyses yielded similar estimates of D-dimer effect to distinguish risk for recurrent VTE. The IPD approach was justified by the need to investigate sources of heterogeneity.
AB - Objective: We compared the performance of aggregate data (AD)-based and individual patient data (IPD)-based meta-analyses to synthesize evidence on the ability of D-dimer to distinguish recurrence risk in patients with unprovoked venous thromboembolism (VTE) who stopped anticoagulation. Study Design and Setting: We compared the results of the published AD-based rate ratio of VTE recurrence for positive vs. negative D-dimer, estimated by a mixed-effect Poisson model, with those of the IPD-based hazard ratio obtained by a Cox regression stratified by trial. We performed three additional analyses to investigate the methodological reasons for differences between the two approaches, comparing the IPD Cox regression with AD generated from IPD Poisson regression (to control for differences in population on study), AD time-to-event meta-analysis, and AD generated from IPD meta-regression. Results: Published analyses agreed in direction and statistical significance when estimating the prognostic value of D-dimer even if IPD estimates suggested a stronger effect. The additional analyses suggested that differences in study populations might explain this slight difference. Poor reporting in published studies precluded a true comparison of AD- and IPD-based assessments of heterogeneity sources. Conclusion: AD and IPD meta-analyses yielded similar estimates of D-dimer effect to distinguish risk for recurrent VTE. The IPD approach was justified by the need to investigate sources of heterogeneity.
KW - D-dimer
KW - Individual patient data
KW - Meta-analysis
KW - Prognosis
KW - Sources of heterogeneity
KW - Time to event
UR - http://www.scopus.com/inward/record.url?scp=84875264421&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84875264421&partnerID=8YFLogxK
U2 - 10.1016/j.jclinepi.2012.08.007
DO - 10.1016/j.jclinepi.2012.08.007
M3 - Article
C2 - 23395515
AN - SCOPUS:84875264421
VL - 66
SP - 415
EP - 425
JO - Journal of Clinical Epidemiology
JF - Journal of Clinical Epidemiology
SN - 0895-4356
IS - 4
ER -