Individual patient data meta-analysis: a promising approach for evidence synthesis in reproductive medicine

被引:41
作者
Broeze, Kimiko A. [1 ,2 ]
Opmeer, Brent C. [2 ]
van der Veen, Fulco [1 ]
Bossuyt, Patrick M. [2 ]
Bhattacharya, Siladitya [3 ]
Mol, Ben W. J. [1 ,2 ]
机构
[1] Univ Amsterdam, Acad Med Ctr, Dept Obstet & Gynaecol, Ctr Reprod Med, NL-1105 AZ Amsterdam, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Dept Clin Epidemiol Biostat & Bioinformat, NL-1105 AZ Amsterdam, Netherlands
[3] Aberdeen Matern Hosp, Dept Obstet & Gynaecol, Aberdeen, Scotland
关键词
systematic review; individual patient data meta-analysis; embryo transfer; tubal pathology; ovarian reserve; RANDOMIZED CONTROLLED-TRIALS; PREDICTING OVARIAN RESERVE; IN-VITRO FERTILIZATION; SYSTEMATIC REVIEWS; TUBAL PATHOLOGY; EMBRYO-TRANSFER; DIAGNOSTIC-TEST; ACCURACY; QUALITY; MODELS;
D O I
10.1093/humupd/dmq043
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Systematic reviews and accompanying meta-analyses are the cornerstones of evidence-based medicine. Systematic reviews summarize clinical evidence; meta-analyses provide summary estimates of the treatment effect or the diagnostic test accuracy. Although deemed to provide the highest level of evidence, their clinical value is limited as they can only summarize aggregated data. In these meta-analyses the true variability of the treatment effects cannot be explored to the desired extent, because the meta-analyses cannot distinguish between patients with different clinical profiles. Systematic reviews and meta-analyses based on individual patient data (IPD), described as the 'gold standard' for systematic reviews are a promising approach that might overcome these limitations. IPD meta-analyses allow treatment effects and diagnostic accuracy to be estimated at the level of relevant patient subgroups. This enables researchers to investigate the effectiveness of treatment in patients with different profiles. In this article, we address the opportunities of systematic reviews and meta-analyses using IPD in reproductive medicine. We discuss its potential based on three clinical examples: single versus double embryo transfer in IVF, the diagnosis of tubal pathology and the prognostic value of ovarian reserve tests. We propose to show potential advantages of IPD systematic reviews and meta-analyses in providing stratified clinical evidence, which could improve medical care.
引用
收藏
页码:561 / 567
页数:7
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