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Addressing Methodologic Challenges and Minimizing Threats to Validity in Synthesizing Findings from Individual Level Data Across Longitudinal Randomized Trials

机译:在纵向随机试验中综合个人水平数据的发现中应对方法学挑战并最大程度地降低对有效性的威胁

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摘要

Integrative Data Analysis (IDA) encompasses a collection of methods for data synthesis that pools participant-level data across multiple studies. Compared to single-study analyses, IDA provides larger sample sizes, better representation of participant characteristics, and often increased statistical power. Many of the methods currently available for IDA have focused on examining developmental changes using longitudinal observational studies employing different measures across time and study. However, IDA can also be useful in synthesizing across multiple randomized clinical trials to improve our understanding of the comprehensive effectiveness of interventions, as well as mediators and moderators of those effects. The pooling of data from randomized clinical trials presents a number of methodological challenges, and we discuss ways to examine potential threats to internal and external validity. Using as an illustration a synthesis of 19 randomized clinical trials on the prevention of adolescent depression, we articulate IDA methods that can be used to minimize threats to internal validity, including (1) heterogeneity in the outcome measures across trials, (2) heterogeneity in the follow-up assessments across trials, (3) heterogeneity in the sample characteristics across trials, (4) heterogeneity in the comparison conditions across trials, and (5) heterogeneity in the impact trajectories. We also demonstrate a technique for minimizing threats to external validity in synthesis analysis that may result from non-availability of some trial datasets. The proposed methods rely heavily on latent variable modeling extensions of the latent growth curve model, as well as missing data procedures. The goal is to provide strategies for researchers considering IDA.
机译:集成数据分析(IDA)包含了数据综合方法的集合,这些方法汇总了多个研究中的参与者级数据。与单项研究分析相比,IDA提供了更大的样本量,更好的参与者特征表示,并且通常提高了统计能力。当前可用于IDA的许多方法都侧重于使用纵向观察性研究来检查发育变化,这些研究采用跨时间和跨研究的不同措施。但是,IDA还可用于综合多个随机临床试验,以增进我们对干预措施以及这些效应的介体和调节剂的综合效力的理解。来自随机临床试验的数据汇总提出了许多方法上的挑战,我们讨论了检查内部和外部有效性的潜在威胁的方法。以19项关于预防青少年抑郁症的随机临床试验的综述为例,我们阐述了IDA方法,这些方法可用于最大程度地减少对内部有效性的威胁,包括(1)各个试验结果指标的异质性,(2)异质性。各个试验的后续评估,(3)各个试验的样本特征的异质性,(4)各个试验的比较条件的异质性和(5)冲击轨迹的异质性。我们还展示了一种用于最小化综合分析中可能由于某些试验数据集不可用而导致的外部有效性威胁的技术。所提出的方法在很大程度上依赖于潜在增长曲线模型的潜在变量建模扩展,以及缺少的数据过程。目的是为研究人员提供考虑IDA的策略。

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