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Based on results of the runMetaAnalysis(), this function allows to estimate the proportion of true effect sizes that exceed a user-defined meaningful (e.g. clinically relevant) threshold.

Usage

proportionMID(model, 
              mid = NULL, 
              which = "all", 
              test = "smaller", 
              plot = FALSE)

Arguments

model

A class runMetaAnalysis object, created by the runMetaAnalysis() function.

mid

A numeric value, indicating a clinically relevant effect threshold (e.g. a minimally important difference; \(MID\); Cuijpers et al., 2014) that should be used to estimate the proportion of true effect sizes that exceed this cut-off. If the outcome measure used in model is Hedges' \(g\), the provided value should also be a standardized mean difference. If the outcome measure of model is a risk ratio, the treshold should also be provided as an (untransformed) risk ratio.

which

The model in model that should be used to estimate the proportions. Defaults to "all", which means that proportions are calculated for all models. Alternatively, possible values are "overall", "combined", "lowest", "highest", "outliers", "influence" and "rob", if these models are available in the model object. If correctPublicationBias() has been run, "trimfill", limitmeta and selection are also possible options. It is also possible to concatenate model names, meaning that proportions are calculated for all the supplied models.

test

By default, the function estimates the proportion of true effects below the provided threshold in mid (test="smaller"). Alternatively, one can specify test="bigger". This will calculate the proportion of true effects above the treshold.

plot

Should a density plot illustrating the proportions be returned? Defaults to FALSE. Please note that an S3 plot method is available for outputs of this function even when plot=FALSE (see "Details").

Value

Returns an object of class "proportionMID". An S3 plot method is defined for this object class, which allows to create a density plot illustrating the estimated proportions, using the model-based estimate of the pooled effect size and between-study heterogeneity \(\tau^2\).

Details

The proportionMID function implements an approach to estimate the proportion of true effect sizes exceeding a (scientifically or clinically) relevant threshold, as proposed by Mathur & VanderWeele (2019). These estimated proportions have been suggested as a useful metric to determine the impact that between-study heterogeneity in a meta-analysis has on the "real-life" interpretation of results.

If, for example, a pooled effect is significant, high between-study heterogeneity can still mean that a substantial proportion of true effects in the studies population are practicially irrelevant, or even negative. Conversely overall non-significant effects, in the face of large heterogeneity, can still mean that a substantial proportion of studies have non-negligible true effects.

As recommended by Mathur & VanderWeele (2019), the proportionMID function also automatically calculates the proportion of true effects exceeding the "inverse" of the user-defined effect (e.g., if mid=-0.24, by default, the function also estimates the proportion of true effects that is larger than \(g\)=0.24; note the changed sign). This can be used to check for e.g. clinically relevant negative effects.

When the plot method is used, or when plot is set to TRUE in the function, a plot showing the assumed distribution of true effects based on the estimated meta-analytic model is created. Notably, is is assumed that the random-effects distribution of true effect sizes is approximately normal. This simplifying assumption is required for this (and many other meta-analytic methods; Jackson & White, 2018) to hold.

Confidence intervals provided by the functions are calculated using the asymptotic closed-form solution derived using the Delta method in Mathur & VanderWeele (2019). Following their recommendations, a warning is printed when \(p\)<0.15 or \(p\)>0.85, since in this case the asymptotic CIs should be interpreted cautiously; CIs based on boostrapping would be preferable in this scenario and can be calculated using the MetaUtility::prop_stronger() function.

References

Cuijpers, P., Turner, E. H., Koole, S. L., Van Dijke, A., & Smit, F. (2014). What is the threshold for a clinically relevant effect? The case of major depressive disorders. Depression and Anxiety, 31(5), 374-378.

Jackson, D., & White, I. R. (2018). When should meta-analysis avoid making hidden normality assumptions?. Biometrical Journal, 60(6), 1040-1058.

Mathur, M. B., & VanderWeele, T. J. (2019). New metrics for meta-analyses of heterogeneous effects. Statistics in Medicine, 38(8), 1336-1342.

Author

Mathias Harrer mathias.h.harrer@gmail.com, Paula Kuper paula.r.kuper@gmail.com, Pim Cuijpers p.cuijpers@vu.nl

Examples

if (FALSE) {
# Run meta-analysis; then estimate the proportion
depressionPsyCtr %>% 
  filterPoolingData(condition_arm1 == "cbt") %>% 
  runMetaAnalysis()  -> x

proportionMID(x, mid = -0.24)
proportionMID(x, mid = -0.24, "outliers") %>% plot()


# If bootstrap CIs are requested in runMetaAnalysis,
# calculation of CIs around p is possible for all available
# models.
depressionPsyCtr %>% 
  filterPoolingData(condition_arm1 == "cbt") %>% 
  runMetaAnalysis(i2.ci.boot = TRUE, nsim.boot = 1000) %>% 
  correctPublicationBias() -> x

proportionMID(x, mid = -0.33)

# Run meta-analysis based on RRs; then estimate proportion
# of true effects bigger than the defined threshold
depressionPsyCtr %>% 
  filterPoolingData(
    condition_arm1 %in% c("cbt", "pst", 
                          "dyn", "3rd wave")) %>% 
  runMetaAnalysis(es.measure = "RR") %>% 
  proportionMID(mid = 1.13, test = "bigger")
}