Paper detail

Meta-Analysis of Odds Ratios With Incomplete Extracted Data

A typical random effects meta-analysis of odds-ratios assumes binomially distributed numbers of events in a treatment and control group and requires the proportion of deaths to be extracted from published papers. This data is often not available in the publications due to loss to follow-up. When the Kaplan Meier survival plot is available, it is common practice to manually measure the needed information from the plot and infer the probability of survival and then to infer a best-guess of the number of deaths. Uncertainty introduced from theses guesses is not accounted for in current models. This naive approach leads to over-certain results and potentially inaccurate conclusions. We propose the Uncertain Reading-Estimated Events model to construct each study's contribution to the meta-analysis separately using the data available for extraction in the publications. We use real and simulated data to illustrate our methods. Meta-analysis based on the observed number of deaths lead to biased estimates while our proposed model does not. Our results show increases in the standard deviation of the log-odds as compared to a naive meta-analysis that assumes ideal extracted data, equivalent to a reduction of the overall sample size of 43% in our example.