A new approach to outliers in meta-analysis

A new approach to outliers in meta-analysis

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Article ID: iaor20091213
Country: Netherlands
Volume: 11
Issue: 2
Start Page Number: 121
End Page Number: 131
Publication Date: Jun 2008
Journal: Health Care Management Science
Authors: ,
Abstract:

The synthesis of evidence from trials and medical studies using meta-analysis is essential for Evidence Based Medicine. However, problematical outlying results often occur even under the random-effects model. We propose a model that allows a long-tailed distribution for the random effect, which removes the necessity for an arbitrary decision to include or exclude outliers. In this approach, they are included, but with a reduced weight. We also introduce a modification of the forest plot to show the downweighting of outliers. We illustrate the methodology and its usefulness by carrying out both frequentist and Bayesian meta-analyses using data sets from the Cochrane Collaboration.

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