Sequential methods for random‐effects meta‐analysis

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Abstract
Although meta‐analyses are typically viewed as retrospective activities, they are increasingly being applied prospectively to provide up‐to‐date evidence on specific research questions. When meta‐analyses are updated account should be taken of the possibility of false‐positive findings due to repeated significance tests. We discuss the use of sequential methods for meta‐analyses that incorporate random effects to allow for heterogeneity across studies. We propose a method that uses an approximate semi‐Bayes procedure to update evidence on the among‐study variance, starting with an informative prior distribution that might be based on findings from previous meta‐analyses. We compare our methods with other approaches, including the traditional method of cumulative meta‐analysis, in a simulation study and observe that it has Type I and Type II error rates close to the nominal level. We illustrate the method using an example in the treatment of bleeding peptic ulcers. Copyright © 2010 John Wiley & Sons, Ltd.
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