Abstract
Background: A fixed effects meta-analysis of ten exercise training in trials heart failure patients was conducted. The aim of this current work was to compare different approaches to meta-analysis using the same dataset from the previous work on ten exercise training trials in heart failure patients.Methods: The following different meta-analysis techniques were used to analyse the data and compared the effects of exercise training on BNP, NTpro-BNP and peak VO2 before and after exercise training:(1) Trial level (traditional) level MAi) Follow up (post-exercise training intervention) outcome only.ii) Baseline-follow up difference(2) Patient level MA by Post-Stage ANCOVAi) naive model does not take into account trial levelii) Single Stageiii) Two Stage(3) Post outcome onlyi) Single stageii) Pre-post outcome difference Single stageResults: The Individual patient data (IPD) analyses produced smaller effect sizes and 95% confidence intervals compared to conventional meta-analysis. The advantage of the one-stage model is that it allows sub-group analyses, while the two-stage model is considered more robust but limited for sub-analyses.Conclusions: Our recommendation is to use one-stage or two-stageANCOVA analysis, the former allows sub-group analysis, while the latter is considered to be more technically robust.
Highlights
A fixed effects meta-analysis of ten exercise training in trials heart failure patients was conducted
I) naive model does not take into account trial level ii)
The Individual patient data (IPD) analyses produced smaller effect sizes and 95% confidence intervals compared to conventional metaanalysis
Summary
A fixed effects meta-analysis of ten exercise training in trials heart failure patients was conducted. Methods: The following different meta-analysis techniques were used to analyse the data and compared the effects of exercise training on BNP, NTpro-BNP and peak VO2 before and after exercise training: (1). Trial level (traditional) level MA i) Follow up (post-exercise training intervention) outcome only. Meta-analyses are based on systematic reviews and are regarded as the gold standard for the practise of evidence-based medicine Such analyses are typically based on study level group data that may be incomplete across all included studies. The obvious potential limitation of IPD is obtaining raw data from authors and permission to use it Gaining this permission typically involves setting up an IPD trial collaboration. A notable example in exercise training for heart failure patients is ExTraMATCH 1
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