Sequential meta-analysis

Jafri NS et al Meta-analysis Sequential therapy appears superior to standard therapy for Helicobacter pylori infection in patients naive to treatment. Ann Intern Med 2008 148 923. [PMID 18490667]... 

This is an issue which has received much attention elsewhere but which is generally seen to be less relevant within the context of drug development. If one performs regular meta-analyses of clinical trials and then stops doing clinical trials if or when the result of the meta-analysis becomes signlflcant, then such a procedure is subject to the general bias to which (unadjusted) sequential clinical analysis of ordinary clinical trials is liable. 

Taylor and Potts performed a meta-analysis and found that independent double reading increases the number of cancers detected by 13%, whereas the recall rate increases by 31%. These numbers are comparable with what is found by the clinical CADe studies that used the sequential or cross-sectional method (9% increase in the number of cancers detected), with CADe having a lower increase in the recall rate (10%),... 

Meta-analysis, Group Sequential Study Designs, Centralized Endpoint Adjudication, and Composite Endpoints... 

A group sequential approach was planned to discharge the 1.3 threshold. The significance levels for the multiple analyses were based on the Lan-DeMets spending function with an O Brien-Fleming boundary. The first analysis to discharge it would be conducted at the time when the meta-analysis to discharge the 1.8 threshold was performed. The next planned interim meta-analysis would be conducted when approximately 500 MACE-plus events had accrued, and a final interim analysis was planned to occur after approximately 700 events had accumulated, if the E3... 

Chatterjee S, Wetterslev J, Sharma A, lichstein E, Mukherjee D. Association of blood transfusion with increased mortality in myocardial infarction a meta-analysis and diversity-adjusted study sequential analysis. JAMA Intern Med 2013 173(2) 132-9. 

Haase N, Pemer A, Hennings LI, Siegemund M, Lauridsen B, Wetterslev M, et al. Hydroxyethyl starch 130/0.38-0.45 versus crystalloid or albiunin in patients with sepsis systematic review with meta-analysis and trial sequential analysis. Bmj 2013 15(346). 

---