摘要
AIM: To study the validity of the fixed, random, and multivariate meta-analytical models applied in meta-analyses in artificial reproduction technique. METHODS: Based on common characteristics of in vitro fertilization(IVF) meta-analyses, we simulated a large number of data to compare results issued from the fixed model(FM) with the random model(RM). For multiple endpoints meta-analysis(MA), we compared the univariate RM with the multivariate model(MM). Finally, we illustrate our findings in re-analyzing a recent MA. RESULTS: In our review, although a homogeneous effect was excluded in 89% of the MAs(11%), FM was utilized in 41 studies(82%). From simulations, a concordance of 59% ± 6% was found between the two tests, with up to 65% of falsely significant results with FM. The Q-test on studies characterized by substantial heterogeneity falsely accepted homogeneity in 46% of studies. Comparing separate univariate RM and MM on multiple endpoints studies, MM reduces the between endpoint discrepancy(BED) of 68%, and increases the power of 57% ± 8%. In the example dealing with the controversial effect of luteneizing hormone supplementation to follicle stimulating hormone during ovarian stimulation in IVF cycles, MM reduced BED by 66%, and consistent effects were found for all the endpoints, irrespective of partial reporting. CONCLUSION: The FM generally may produce falsely significant differences. The RM should always be used. For multiple endpoints, the MM constitutes the best option.
AIM： To study the validity of the fixed, random, and multivariate meta-analytical models applied in metaanalyses in artifcial reproduction technique. METHODS： Based on common characteristics of in vitro fertilization （IVF） meta-analyses, we simulated a large number of data to compare results issued from the fxed model （FM） with the random model （RM）. For multiple endpoints meta-analysis （MA）, we compared the univariate RM with the multivariate model （MM）. Finally, we illustrate our fndings in re-analyzing a recent MA. RESULTS： In our review, although a homogeneous effect was excluded in 89% of the MAs （11%）, FM was utilized in 41 studies （82%）. From simulations, a concordance of 59% ± 6% was found between the two tests, with up to 65% of falsely signifcant results with FM. The Q-test on studies characterized by substantial heterogeneity falsely accepted homogeneity in 46% of studies. Comparing separate univariate RM and MM on multiple endpoints studies, MM reduces the between endpoint discrepancy （BED） of 68%, and increases the power of 57% ± 8%. In the example dealing with the controversial effect of luteneizing hormone supplementation to follicle stimulating hormone during ovarian stimulation in IVF cycles, MM reduced BED by 66%, and consistent effects were found for all the endpoints, irrespective of partial reporting. CONCLUSION： The FM generally may produce falsely signifcant differences. The RM should always be used. For multiple endpoints, the MM constitutes the best option.
