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Abstract Stemming from the high-profile publication of Nissen and Wolski (N Engl J Med 356:2457–2471, 2007) and subsequent discussions with divergent views on how to handle observed zero-total-event studies, defined to be studies that observe zero number of event in both treatment and control arms, the research topic concerning the common odds ratio model with zero-total-event studies remains to be an unresolved problem in meta-analysis. In this article, we address this problem by proposing a novel repro samples method to handle zero-total-event studies and make inference for the common odds ratio. The development explicitly accounts for the sampling scheme that generates the observed data and does not rely on any large sample approximations. It is theoretically justified with a guaranteed finite-sample performance. Simulation studies are designed to demonstrate the empirical performance of the proposed method. It shows that the proposed confidence set, although a little conservative, achieves the desired empirical coverage rate in all situations. The development also shows that the zero-total-event studies contain meaningful information and impact the inference for the common odds ratio. The proposed method is used to perform a meta-analysis of the 48 trials reported in Nissen and Wolski (N Engl J Med 356:2457–2471, 2007) as well 

The main objective of most clinical trials is to estimate the effect of some treatment compared to a control condition. We define the signal‐to‐noise ratio (SNR) as the ratio of the true treatment effect to the SE of its estimate. In a previous publication in this journal, we estimated the distribution of the SNR among the clinical trials in the Cochrane Database of Systematic Reviews (CDSR). We found that the SNR is often low, which implies that the power against the true effect is also low in many trials. Here we use the fact that the CDSR is a collection of meta‐analyses to quantitatively assess the consequences. Among trials that have reached statistical significance we find considerable overoptimism of the usual unbiased estimator and under‐coverage of the associated confidence interval. Previously, we have proposed a novel shrinkage estimator to address this “winner's curse.” We compare the performance of our shrinkage estimator to the usual unbiased estimator in terms of the root mean squared error, the coverage and the bias of the magnitude. We find superior performance of the shrinkage estimator both conditionally and unconditionally on statistical significance.