Explanation of trial sequential analysis: using a post-hoc analysis of meta-analyses published in Korean Journal of Anesthesiology

De Cassai Alessandro; Tassone Martina; Geraldini Federico; Sergi Massimo; Sella Nicolò; Boscolo Annalisa; Munari Marina

doi:10.4097/kja.21218

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저자정보: De Cassai Alessandro (Padova University Hospital) Tassone Martina (Department of Medicine-DIMED University of Padua) Geraldini Federico (UOC Anesthesia and Intensive Care Unit University Hospital of Padua) Sergi Massimo (UOC Anesthesia and Intensive Care Unit University Hospital of Padua) Sella Nicolò (UOC Anesthesia and Intensive Care Unit University Hospital of Padua) Boscolo Annalisa (UOC Anesthesia and Intensive Care Unit University Hospital of Padua) Munari Marina (UOC Anesthesia and Intensive Care Unit University Hospital of Padua)

저널정보: 대한마취통증의학회(구 대한마취과학회) Korean Journal of Anesthesiology Korean Journal of Anesthesiology Vol.74 No.5

발행연도: 2021.10

수록면: 383 - 393 (11page)

DOI: 10.4097/kja.21218

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Background: Trial sequential analysis (TSA) is a recent cumulative meta-analysis method used to weigh type I and II errors and to estimate when the effect is large enough to be unaffected by further studies. The aim of this study was to illustrate possible TSA scenarios and their significance using meta-analyses published in the Korean Journal of Anesthesiology (KJA) as working material. Methods: We performed a systematic medical literature search for meta-analyses published in the KJA. TSA was performed on each main outcome, estimating the required sample size on the calculated effect size for the intervention, considering a type I error of 5% and a power of 90% or 99%. Results: Six meta-analyses with a total of ten main outcomes were included in the analysis. Seven TSAs confirmed the results of the meta-analyses. However, only three of them reached the required sample size. In the two TSAs, the cumulative z-lines were not statistically significant. One TSA boundary for effect was reached with the 90% analysis, but not with the 99% analysis. Conclusions: In TSA, a meta-analysis pooled effect may be established to assess if the cumulative sample size is large enough. TSA can be used to add strength to the conclusions of meta-analyses; however, pre-registration of the TSA protocol is of paramount importance. This study could be useful to better understand the use of TSA as an additional statistical tool to improve meta-analysis quality.

#Anesthesia #Medical education #Meta-analysis #Review #Sample size #Statistics.

참고문헌 (16)

참고문헌 신청

Wetterslev J / 2017 / Trial Sequential Analysis in systematic reviews with meta-analysis / BMC Med Res Methodol 17:39

Wetterslev J / 2008 / Trial sequential analysis may establish when firm evidence is reached in cumulative meta-analysis / J Clin Epidemiol 61:64~75

De Cassai A / 2021 / Serratus anterior plane block for video-assisted thoracoscopic surgery : a meta-analysis of randomised controlled trials / Eur J Anaesthesiol 38:106~114

De Cassai A / 2021 / Effect of dexmedetomidine on hemodynamic responses to tracheal intubation : a meta-analysis with meta-regression and trial sequential analysis / J Clin Anesth 72:110287

De Cassai Alessandro / 2021 / Trial sequential analysis: plain and simple / Korean Journal of Anesthesiology 74(4):363~365

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De Cassai Alessandro

소속기관 Padova University Hospital

주요연구분야 의약학 > 임상의학 > 마취과학

논문수 4 이용수 0

Tassone Martina

소속기관 Department of Medicine-DIMED University of Padua

주요연구분야 의약학 > 임상의학 > 마취과학

논문수 1 이용수 0

Geraldini Federico