Abstract

BackgroundIn systematic reviews and meta-analysis, researchers often pool the results of the sample mean and standard deviation from a set of similar clinical trials. A number of the trials, however, reported the study using the median, the minimum and maximum values, and/or the first and third quartiles. Hence, in order to combine results, one may have to estimate the sample mean and standard deviation for such trials.MethodsIn this paper, we propose to improve the existing literature in several directions. First, we show that the sample standard deviation estimation in Hozo et al.’s method (BMC Med Res Methodol 5:13, 2005) has some serious limitations and is always less satisfactory in practice. Inspired by this, we propose a new estimation method by incorporating the sample size. Second, we systematically study the sample mean and standard deviation estimation problem under several other interesting settings where the interquartile range is also available for the trials.ResultsWe demonstrate the performance of the proposed methods through simulation studies for the three frequently encountered scenarios, respectively. For the first two scenarios, our method greatly improves existing methods and provides a nearly unbiased estimate of the true sample standard deviation for normal data and a slightly biased estimate for skewed data. For the third scenario, our method still performs very well for both normal data and skewed data. Furthermore, we compare the estimators of the sample mean and standard deviation under all three scenarios and present some suggestions on which scenario is preferred in real-world applications.ConclusionsIn this paper, we discuss different approximation methods in the estimation of the sample mean and standard deviation and propose some new estimation methods to improve the existing literature. We conclude our work with a summary table (an Excel spread sheet including all formulas) that serves as a comprehensive guidance for performing meta-analysis in different situations.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2288-14-135) contains supplementary material, which is available to authorized users.

Highlights

  • In systematic reviews and meta-analysis, researchers often pool the results of the sample mean and standard deviation from a set of similar clinical trials

  • While individual trial study could fail to show a statistically significant treatment effect, systematic reviews and meta-analysis of combined results might reveal the potential benefits of treatment

  • With the combination of several studies and more data taken into consideration in systematic reviews, the accuracy of estimations will get improved and more precise interpretations towards the treatment effect can be achieved via meta-analysis

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Summary

Introduction

In systematic reviews and meta-analysis, researchers often pool the results of the sample mean and standard deviation from a set of similar clinical trials. Prior to the 1990s, the traditional approach to combining results from multiple trials is to conduct narrative (unsystematic) reviews, which are mainly based on the experience and subjectivity of experts in the area [2]. This approach suffers from many critical flaws. With the combination of several studies and more data taken into consideration in systematic reviews, the accuracy of estimations will get improved and more precise interpretations towards the treatment effect can be achieved via meta-analysis

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