Bayesian Meta-analysis Research Articles

Identification of predictive factors interacting with heart rate reduction for potential beneficial clinical outcomes in chronic heart failure: A systematic literature review and meta-analysis.

There is an absence of clinical evidence on what factors modify the effect of heart rate (HR)-reducing treatment on mortality and morbidity in symptomatic heart failure patients with reduced ejection fraction (HFrEF). We performed a Bayesian meta-analysis and meta-regression to identify predictive factors that interact with HR-reducing therapy. A systematic review was performed to identify randomized placebo-controlled trials that enrolled symptomatic HFrEF patients. The primary objective was to evaluate how different predictive factors modify the efficacy of HR-reducing therapy on clinical outcomes. Secondary objectives included the evaluation of subgroups stratified by a HR reduction threshold of 10bpm. Data from 20 studies were synthesized and HR-reducing therapy was responsible for 16.7%, 16.4%, and 21.1% risk reductions in all-cause mortality, cardiovascular (CV)-related mortality, and rehospitalization due to worsening HF (WHF), respectively. Empirical Bayes meta-regression showed that type 2 diabetes mellitus (T2DM) significantly modified the efficacy of HR-reducing therapy on all-cause mortality (slope=0.012 in log risk ratio (RR) per 1%-unit [95% credible interval (CrI) 0.004, 0.021]) and CV-related mortality (0.01 in log RR per 1%-unit [95% CrI 0.0003, 0.0200]). There were insufficient studies to perform a meta-regression when stratifying by a HR reduction threshold of 10bpm; however, when including all studies, we observed a significant effect modification for rehospitalization due to WHF (p=0.004). This meta-analysis focused on the central tenet of HR-reducing therapy and revealed that T2DM is a predictor of HR-reducing treatment effect on all-cause mortality and CV-related mortality in HFrEF patients.

Two- versus multi-rod constructs for adult spinal deformity: A systematic review and Random-effects and Bayesian meta-analysis

BackgroundSurgical approaches in adult spinal deformity are associated with high rates of adverse events including hardware failure and rod fracture. Recently, some reports have emerged comparing multiple-rod constructs with 2-rod constructs suggesting potential benefits with the former. However, these have been limited by variability in observed outcomes, which have limited the change of paradigm in adult spinal deformity surgery. ObjectiveTo compare the rate of rod fracture, pseudoarthrosis, proximal junctional kyphosis and re-operation between 2-RC and M-RC. MethodsMEDLINE/Pubmed, Web of Science and Embase were searched without language restrictions for relevant articles from inception until October 2021. All observational cohort studies assessing patients with ADS undergoing 3-column osteotomy and comparing 2-RC with M-RC procedures on pseudarthrosis, rod fracture, kyphosis or reoperation were included. Data were independently extracted by 2 authors. Random-effects and Bayesian meta-analysis were used. ResultsSix primary studies met inclusion criteria, yielding a total of 448 participants, with 223 receiving 2-RC and 225 M-RC. The random-effects meta-analysis pointed to a significantly lower risk of rod fracture associated with M-RC (RR = 0.43, 95 %CI = 0.28–0.66), with moderate heterogeneity being observed (I2 = 20 %, p = 0.28). The random-effects meta-analysis pointed to a lower risk of pseudoarthrosis with M-RC than with 2-RC (RR = 0.49, CI = 0.28–0.84, to a lower rate of re-operation with M-RC than with 2-RC (RR = 0.52, CI = 0.28–0.97) and to a similar rate of proximal junctional kyphosis between 2-RC and M-RC patients (RR = 0.91, CI = 0.60–1.39). Low heterogeneity was observed for studies comparing pseudoarthrosis (I2 = 9 %, p = 0.35), re-operation (I2 = 0 %, p = 0.41) and proximal junctional kyphosis (I2 = 0 %, p = 0.85). DiscussionThese findings suggest that multiple rod-fracture constructs are associated with lower rates of rod fracture, re-operation rates, pseudoarthrosis but not proximal junctional kyphosis. Future studies should address the impact of other modulators of heterogeneity such as body mass index, metal alloys and length of the constructs.

Supplemental Material for Quantifying the Evidence for the Absence of the Job Demands and Job Control Interaction on Workers’ Well-Being: A Bayesian Meta-Analysis

Supplemental Material for Quantifying the Evidence for the Absence of the Job Demands and Job Control Interaction on Workers’ Well-Being: A Bayesian Meta-Analysis

Flat Inferior Vena Cava on Computed Tomography for Predicting Shock and Mortality in Trauma: A Meta-Analysis.

Hypovolemia may be underestimated due to compensatory mechanisms. In this systematic review and meta-analysis, we investigated the diagnostic accuracy of a flat inferior vena cava (IVC) on computed tomography (CT) for predicting the development of shock and mortality in trauma patients. Relevant studies were obtained by searching PubMed, EMBASE, and Cochrane databases (articles up to 16 September 2022). The number of 2-by-2 contingency tables for the index test were collected. We adopted the Bayesian bivariate random-effects meta-analysis model. Twelve studies comprising a total of 1706 patients were included. The flat IVC on CT showed 0.46 pooled sensitivity (95% credible interval [CrI] 0.32-0.63), 0.87 pooled specificity (95% CrI 0.78-0.94), and 0.78 pooled AUC (95% CrI 0.58-0.93) for the development of shock. The flat IVC for mortality showed 0.48 pooled sensitivity (95% CrI 0.21-0.94), 0.70 pooled specificity (95% CrI 0.47-0.88), and 0.60 pooled AUC (95% CrI 0.26-0.89). Regarding the development of shock, flat IVC provided acceptable accuracy with high specificity. Regarding in-hospital mortality, the flat IVC showed poor accuracy. However, these results should be interpreted with caution due to the high risk of bias and substantial heterogeneity in some included studies.

Prognostic impact of secondary prevention medical therapy following myocardial infarction with non-obstructive coronary arteries: a Bayesian and frequentist meta-analysis.

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a clinical entity with several causes and pathophysiologic mechanisms. Secondary prevention with medical therapy used in patients with obstructive coronary artery disease has unclear benefits in MINOCA patients. A literature search was conducted until 8 March 2022. Random-effect frequentist and hierarchical Bayesian meta-analyses were performed to assess the clinical impact of medical therapy [renin-angiotensin-aldosterone system (RAAS) inhibitors, statins, dual antiplatelet therapy (DAPT), β-blockers] in MINOCA patients. Outcomes of interest were all-cause mortality and major adverse cardiovascular events (MACE). A total of 12 663 MINOCA patients among five observational studies were analysed. The mean follow-up ranged from 12 to 90 months across studies. In frequentist meta-analysis, statins and β-blockers were associated with a lower risk of all-cause mortality [pooled adjusted hazard ratios (aHRs) 0.53 and 0.81, with 95% confidence intervals (CIs) (0.37-0.76) and (0.67-0.97), respectively]. Only RAAS inhibitors were associated with a lower risk of MACE [pooled aHR: 0.69, with 95% CI (0.53-0.90)]. Bayesian meta-analysis based on informative prior assumptions offered strong evidence only for the benefit of statins on decreasing the risk of all-cause death [Bayes factor (BF): 33.2] and moderate evidence for the benefit of RAAS inhibitors on decreasing the risk of MACE (BF: 9); assigning less informative prior distributions did not affect the results, yet it downgraded the level of evidence to anecdotal. In this meta-analysis, statins and RAAS inhibitors were consistently associated with a lower risk of all-cause mortality and MACE, respectively, in patients with MINOCA. Neutral prognostic evidence was demonstrated for β-blockers and DAPT.

Immunomodulators in Mechanically Ventilated Patients With COVID-19: Lessons Learned From Underpowered Trials.

Immunomodulators in Mechanically Ventilated Patients With COVID-19: Lessons Learned From Underpowered Trials.

Bayesian Meta-analysis of Direct Oral Anticoagulation Versus Vitamin K Antagonists With or Without Concomitant Antiplatelet After Transcatheter Aortic Valve Implantation in Patients With Anticoagulation Indication.

Patients undergoing transcatheter aortic valve implantation (TAVI) commonly have co-morbidities requiring anticoagulation. However, the optimal post-procedural anticoagulation regimen is not well-established. This meta-analysis investigates safety and efficacy outcomes of direct oral anticoagulants (DOACs) and Vitamin K Antagonist (VKA), with or without concomitant antiplatelet therapy. We searched EMBASE and MEDLINE for appropriate studies. Subgroup analyses were performed for anticoagulant monotherapy and combined therapy with antiplatelet agents. Eleven studies (6359 patients) were included. Overall, there were no differences between DOACs and VKA for all-cause mortality (Odds Ratio [OR]: .69; Credible Interval [CrI]: .40-1.06), cardiovascular-related mortality (OR: .76; Crl: .13-3.47), bleeding (OR: .95; CrI: .75-1.17), stroke (OR: 1.04; CrI: .65-1.63), myocardial infarction (OR: 1.51; CrI: .55-3.84), and valve thrombosis (OR: .29; CrI: .01-3.54). For DOACs vs VKA monotherapy subgroup, there were no differences in outcomes. For the combined therapy subgroup, there was decreased odds of all-cause mortality in the DOACs group compared with the VKA group (OR: .13; CrI: .02-.65), but no differences for bleeding and stroke. DOACs and VKA have similar safety and efficacy profiles for post-TAVI patients with anticoagulation indication. However, if concomitant antiplatelet therapy is required, DOACs were more favorable than VKA for all-cause mortality.

Stereotactic Body Radiation Therapy vs. Conventional External Beam Radiation Therapy for Painful Bone Metastases: A Systematic Review and Meta-Analysis of Randomized Trials

<h3>Purpose/Objective(s)</h3> The magnitude of benefit and toxicity of stereotactic body radiation therapy (SBRT) compared with conventional external beam radiation therapy (cEBRT) in treating symptomatic bone metastases is unclear due to the conflicting results from randomized controlled trials (RCTs). We performed a systematic review and meta-analysis to compare the efficacy and safety of SBRT and cEBRT in patients with previously unirradiated painful bone metastases. <h3>Materials/Methods</h3> We searched various databases and major oncologic conference proceedings from inception to Oct 2021 for RCTs comparing SBRT with cEBRT for previously unirradiated painful bone metastases. The outcomes of interest were efficacy (overall and complete pain response rates, local progression, overall survival (OS) and quality of life (QoL)) and safety (post-irradiation fractures, pain flares and radiation myelopathy). We assessed the methodologic quality of individual trials using the revised Cochrane risk-of-bias (RoB2) tool. We performed one-stage individual patient data meta-analysis using multilevel logistic regression model. Sensitivity analyses were conducted using two-stage frequentist and Bayesian meta-analyses. We adopted Synthesis Without Meta-analysis (SWiM) approach to summarize adverse events and quality of life outcomes. We assessed the certainty of the evidence for the efficacy outcomes using GRADE approach. <h3>Results</h3> Six RCTs including 894 patients were identified. Five of the included trials had low risk of bias. There was no significant difference in overall pain response rates at 3 months between SBRT and cEBRT (odd ratio (OR), 1.10; 95% confidence interval (CI), 0.84-1.44; P, 0.48; GRADE, moderate certainty). SBRT significantly improved complete pain response rates at 3 months (OR, 3.38; 95% CI, 1.88-6.07; P< 0.01; GRADE, high certainty) and reduced local progression rates (OR, 0.15; 95% CI, 0.04-0.53; P< 0.01; GRADE, high certainty), compared to cEBRT. Sensitivity analyses showed consistent findings. SBRT was associated with a modest increase in pain flare rates, compared to cEBRT. There were no significant differences between the two groups in OS, post-irradiation fracture and radiation myelopathy. The QoL was similar, except for improved perception of financial burden with SBRT at 4 weeks. <h3>Conclusion</h3> Among the patients with previously unirradiated symptomatic bone metastases, SBRT significantly improved complete but not overall pain response rates at 3 months and delayed local progression without adversely impacting on the quality of life and overall survival, compared to cEBRT. SBRT was associated with a modest increase in the pain flare rates, compared to cEBRT.

Interventions to improve the quality of screening-related colonoscopy: protocol for a systematic review and network meta-analysis of randomised controlled trials

IntroductionColonoscopy quality can vary depending on endoscopist-related factors. Quality indicators, such as adenoma detection rate (ADR), have been adopted to reduce variations in care. Several interventions aim to improve ADR,...

CANCER RISK WITH TOPICAL PIMECROLIMUS AND TACROLIMUS FOR ATOPIC DERMATITIS: SYSTEMATIC REVIEW AND BAYESIAN META-ANALYSIS

<h3>Introduction</h3> Atopic dermatitis (AD) affects millions worldwide and is effectively managed by topical treatments, including the topical calcineurin inhibitors (TCIs), pimecrolimus and tacrolimus. In 2005 and 2011, the FDA released reviews associating TCIs with theoretical cancer risk, albeit with uncertainty. We systematically reviewed the cancer risk in patients with AD exposed to TCIs. <h3>Methods</h3> The AAAAI/ACAAI Joint Task Force on Practice Parameters systematically identified randomized controlled trials (RCT), comparative, and non-comparative non-randomized studies (NRS) from inception to June 6, 2022, from MEDLINE, EMBASE, GREAT, LILACS, ICTRP, FDA, EMA, company registers, and relevant citations. We included studies in any language addressing the risk of cancer in patients with AD exposed to TCIs for greater than 3 weeks. We excluded split-body studies. We conducted a random-effects Bayesian meta-analysis and used GRADE to rate the certainty of evidence. A multidisciplinary panel including patient partners determined thresholds for important risks. <h3>Results</h3> We analyzed 121 studies (52 RCT, 69 NRS) including 3.4 million patients followed for a mean of 11 months (range 0.7–150). The absolute risk of any cancer with TCI exposure was neither different from controls (absolute risk: 4.70 per 1000 with TCI, versus 4.56 per 1000 without; odds ratio: 1.03 [95%CrI 0.94–1.11], moderate-certainty evidence), nor the general U.S. population (4.6 per 1000). Findings were similar in infants, children, and adults, and were robust to trial sequential, subgroup, and sensitivity analyses. <h3>Conclusion</h3> Among infants, children, and adults with AD, moderate-certainty evidence shows that TCIs are not associated with increased cancer risk. These findings support the safe use of TCIs in the management of patients with AD.

Trans-ancestry, Bayesian meta-analysis discovers 20 novel risk loci for inflammatory bowel disease in an African American, East Asian and European cohort.

Inflammatory bowel disease (IBD) is an immune-mediated chronic intestinal disorder with major phenotypes: ulcerative colitis (UC) and Crohn's disease (CD). Multiple studies have identified over 240 IBD susceptibility loci. However, most studies have centered on European (EUR) and East Asian (EAS) populations. The prevalence of IBD in non-EUR, including African Americans (AAs), has risen in recent years. Here we present the first attempt to identify loci in AAs using a trans-ancestry Bayesian approach (MANTRA) accounting for heterogeneity between diverse ancestries while allowing for the similarity between closely related populations. We meta-analyzed genome-wide association studies (GWAS) and Immunochip data from a 2015 EUR meta-analysis of 38 155 IBD cases and 48 485 controls and EAS Immunochip study of 2824 IBD cases and 3719 controls, and our recent AA IBD GWAS of 2345 cases and 5002 controls. Across the major IBD phenotypes, we found significant evidence for 92% of 205 loci lead SNPs from the 2015 meta-analysis, but also for three IBD loci only established in latter studies. We detected 20 novel loci, all containing immunity-related genes or genes with other evidence for IBD or immune-mediated disease relevance: PLEKHG5;TNFSFR25 (encoding death receptor 3, receptor for TNFSF15 gene product TL1A), XKR6, ELMO1, BC021024;PI4KB;PSMD4 and APLP1 for IBD; AUTS2, XKR6, OSER1, TET2;AK094561, BCAP29 and APLP1 for CD; and GABBR1;MOG, DQ570892, SPDEF;ILRUN, SMARCE1;CCR7;KRT222;KRT24;KRT25, ANKS1A;TCP11, IL7, LRRC18;WDFY4, XKR6 and TNFSF4 for UC. Our study highlights the value of combining low-powered genomic studies from understudied populations of diverse ancestral backgrounds together with a high-powered study to enable novel locus discovery, including potentially important therapeutic IBD gene targets.

Postpartum hemorrhage drills or simulations and adverse outcomes: a systematic review and Bayesian meta-analysis

Objective To compare the rates of adverse outcomes with postpartum hemorrhage (PPH) before and after implementation of drills or simulation exercises Study eligibility criteria We included all English studies that reported on rates of PPH and associated complications during the pre- and post-implementation of interventional exercises. Study apprasial and synthesis methods Two investigators independently reviewed the abstracts, and full articles for eligibility of all studies. Inconsistencies related to study evaluation or data extraction were resolved by a third author. The co-primary outcomes were the rate of PPH and of any transfusion; the secondary outcomes included admission to the intensive care unit (ICU), transfusion ≥ 4 units of packed red blood cells, hysterectomy, or maternal death. Study effects were combined by Bayesian meta-analysis and reported as risk ratios (RR) and 95% credible intervals (Cr). Results We reviewed 142 full length articles. Of these, 18 publications, with 355,060 deliveries—150,562 (42%) deliveries during the pre-intervention and 204,498 (57.6%) deliveries in the post-interventional period—were included in the meta-analysis. Using the Newcastle-Ottawa Scale, only three studies were considered good quality, and none of them were done in the US. The rate of PPH prior to intervention was 5.06% and 5.46% afterwards (RR 1.09, 95% CI 0.87–1.36; probability of reduction in the diagnosis being 21%). The likelihood of transfusion decreased from 1.68% in the pre-intervention to 1.27% in the post-intervention period (RR 0.80, 95% Cr 0.57–1.09). The overall probability of reduction in transfusion was 93%, albeit it varied among studies done in non-US countries (96%) versus in the US (23%). Transfusion of 4 units or more of blood occurred in 0.44% of deliveries before intervention and 0.37% afterwards (RR of 0.85, 95% CI 0.50–1.52), with the overall probability of reduction being 72% (76% probability of reduction in studies from non-US countries and 49% reduction with reports from the US). Surgical interventions to manage PPH, which was not reported in any US studies, occurred in 0.14% before intervention and 0.28% afterwards (RR 1.29; 95% CI 0.56–3.06; probability of reduction 27%). Admission to the ICU occurred in 0.10% before intervention and 0.08% subsequently (RR 0.92, 95% CI 0.58–1.43), with the overall probability of reduction being 65% (81% in studies from non-US countries and 27% from the study done in the US). Maternal death occurred in 0.17% in the pre-intervention period and 0.09% during the post-intervention (RR 0.62, 95% CI 0.33–1.05; probability of reduction 93% in studies from non-US countries and 82% in one study from the US). Conclusions Interventions to reduce the sequelae of PPH are associated with decrease in adverse outcomes. The conclusion, however, ought not to be accepted reflexively for the US population. All of the studies on the topic done in the US are of poor quality and the associated probability of reduction in sequelae are consistently lower than those done in other countries. Synopsis Since the putative benefits of PPH drills or simulation exercises are based on poor quality pre- and post-intervention trials, policies recommending them ought to be revisited.

Cancer survivor inspiratory muscle training: systematic review and Bayesian meta-analysis

BackgroundThe long-term impact of cancer treatment is associated with respiratory dysfunction and physical fitness impairment. Although inspiratory muscle training (IMT) has been shown as an effective exercise therapy in cancer...

Efficacy of ICD/CRT-D Remote Monitoring in Patients With HFrEF: a Bayesian Meta-analysis of Randomized Controlled Trials.

To evaluate remote monitoring using implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) devices as an adjunctive tool to the traditional care of patients with heart failure (HF). We included 11 trials encompassing 5965 patients. Absolute risk difference (ARD) with 95% credible interval (CrI) was estimated. Pooled (posterior) risk difference was computed using Bayesian hierarchical methods. The ARD for mortality was centered at - 0.01 (95% CrI: - 0.03; 0.01, Tau: 0.02), with an 82% probability of ARD of ICD/CRT-D remote monitoring with respect to control being less than 0. The ARD for cardiovascular mortality was centered at - 0.03 (95% CrI: - 0.11; 0.05, Tau: 0.10), with an 84% probability of ARD of ICD/CRT-D remote monitoring with respect to control being less than 0. ICD/CRT-D remote monitoring in patients with HF is associated with a higher probability of reduced all-cause and cardiovascular mortality compared with standard care alone.

Large genetic divergence underpins cryptic local adaptation across ecological and evolutionary gradients.

Environmentally covarying local adaptation is a form of cryptic local adaptation in which the covariance of the genetic and environmental effects on a phenotype obscures the divergence between locally adapted genotypes. Here, we systematically document the magnitude and drivers of the genetic effect (VG) for two forms of environmentally covarying local adaptation: counter- and cogradient variation. Using a hierarchical Bayesian meta-analysis, we calculated the overall effect size of VG as 1.05 and 2.13 for populations exhibiting countergradient or cogradient variation, respectively. These results indicate that the genetic contribution to phenotypic variation represents a 1.05 to 2.13 s.d. change in trait value between the most disparate populations depending on if populations are expressing counter- or cogradient variation. We also found that while there was substantial variance among abiotic and biotic covariates, the covariates with the largest mean effects were temperature (2.41) and gamete size (2.81). Our results demonstrate the pervasiveness and large genetic effects underlying environmentally covarying local adaptation in wild populations and highlight the importance of accounting for these effects in future studies.

Prognostic impact of secondary prevention treatment following myocardial infarction with non-obstructive coronary arteries: Bayesian versus frequentist meta-analysis

Abstract Background Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a clinical entity with a plethora of causes and pathophysiologic mechanisms. Traditional secondary prevention medications may not offer benefit for patients with MINOCA, calling into question the routine use of such therapies in this population. Material and methods Literature search was conducted in MEDLINE (PubMed), Scopus by ELSEVIER and Cochrane Central Register of Controlled Trials (CENTRAL) databases until 08 March 2022. Random-effects frequentist and hierarchical Bayesian meta-analyses were performed to assess the prognostic impact of secondary prevention medications (β-blockers, RAAS inhibitors, statins, DAPT, ASA and P2Y12 inhibitors) on the occurrence of major adverse cardiovascular events (MACE) and all-cause mortality in MINOCA patients. Sensitivity analyses accounted for the effect of: i. small sample size, ii. limited study follow-up period, and iii. different ethnicity. Results Of 2,569 articles initially retrieved, 9 observational studies were deemed eligible for this analysis, encompassing a total of 14,003 patients suffering from MINOCA (mean follow-up range from 6 to 90 months, mean age = 64.9±10.4 years).Administration of ASA, DAPT and P2Y12 inhibitors was not significantly linked with MACE [pooled adjusted hazard ratios (aHRs) = 0.94, 0.88, and 0.97, with 95% confidence intervals (CIs): 0.56–1.59, 0.47–1.65, and 0.562–1.53, respectively]. RAAS inhibitors and statins were independently associated with lower risk of MACE (pooled aHRs = 0.61 and 0.55 with 95% Cis: 0.46–0.82, and 0.34–0.90, respectively) and all-cause mortality (pooled aHRs = 0.58 and 0.55 with 95% Cis: 0.37–0.91, and 0.43–0.72, respectively). B-blockers were associated with significantly lower risk of all-cause death according to the frequentist analysis (pooled aHR = 0.80, 95% CI: 0.67–0.96) and with non-significantly lower risk of MACE (pooled aHR = 0.81, 95% CI: 0.65–1.01) [Figure 1]. The results deriving from the Bayesian analyses were generally consistent with the frequentist analyses, with the exceptions of the Bayesian analyses on statin and β-blocker effects, which were affected by the pre-test probabilities set herein [Figure 2]. The overall heterogeneity observed in our analyses was relatively small, and there was not substantial publication bias. Furthermore, the performed sensitivity analyses supported the robustness of the observed outcomes. Conclusion In this meta-analysis, it appeared that predominantly RAAS inhibitors and statins across secondary prevention medications were consistently associated with lower risk of MACE or all-cause death during the follow-up period of patients that experienced MINOCA. Funding Acknowledgement Type of funding sources: None.

Theme (concept) paper ‐ Advancing Aggregate Exposure to Chemicals in EU (ExpoAdvance)

Theme (concept) paper ‐ Advancing Aggregate Exposure to Chemicals in EU (ExpoAdvance)

Ethnic differences between South Asians and White Caucasians in cardiovascular disease-related mortality in developed countries: a systematic literature review

BackgroundCardiovascular disease is the leading cause of death worldwide, with significantly worse mortality-related outcomes in ethnic minorities in developed countries. A systematic literature review and meta-analysis of observational studies was conducted to investigate cardiovascular disease-related mortality inequalities between South Asian and White Caucasian ethnic groups.MethodsPublished studies on mortality between South Asians and Whites in developed countries were retrieved from MEDLINE, PubMed, Embase, Web of Science, and grey literature sources (inception—April 2021) and critically appraised using the Quality in Prognosis Studies tool. Bayesian random-effects meta-analyses were performed for both primary and secondary outcomes. Heterogeneity was determined using the I2 statistic.ResultsOf the 9879 studies screened originally, 41 were deemed eligible. A further 3 studies were included via the later search. Of these, 15 reported cardiovascular disease-related mortality, 23 reported all-cause mortality, and 6 reported both.The meta-analysis results showed that South Asians had a significantly increased risk of cardiovascular disease mortality compared to Whites (risk ratio = 1.32; 95% credible interval = 1.14 to 1.54) and a decreased risk of all-cause mortality (risk ratio = 0.95; 95% credible interval = 0.83 to 1.12).DiscussionSouth Asians had statistically significantly higher odds of cardiovascular disease-related mortality compared to Whites, but not for all-cause mortality. Risk of bias was a serious concern mainly due to a lack of confounders being reported.Systematic review registrationPROSPERO: CRD42021240865

Unethical choice in negotiations: A meta-analysis on gender differences and their moderators

Based on role congruity theory, this preregistered meta-analysis examines whether women negotiate less unethically than men. We predicted that moderators related to the person (negotiation experience) and the negotiation context (e.g., advocacy, cultural gender-role inequality) influence the proposed gender difference. We conducted a Bayesian three-level meta-analysis to test our predictions on a sample of 116 effect sizes from 70 samples (overall N = 14,028, including employees, MBA students, undergraduate students). As predicted, women negotiated less unethically than men (Hedges’ g = 0.25). The gender difference held for unethical judgements (Hedges’ g = 0.29), unethical intentions (Hedges’ g = 0.21), and unethical behaviors (Hedges’ g = 0.17). The gender difference decreased when parties negotiated for others as compared to for themselves, when parties strategically used positive affect, and tended to decrease when parties were experienced as compared to inexperienced negotiators. We discuss implications for theory and research.

Interpreting magnitude of change in strength and conditioning: Effect size selection, threshold values and Bayesian updating

ABSTRACT The magnitude of change following strength and conditioning (S&C) training can be evaluated comparing effect sizes to thresholds. This study conducted a series of meta-analyses and compiled results to identify thresholds specific to S&C, and create prior distributions for Bayesian updating. Pre- and post-training data from S&C interventions were translated into standardised mean difference (SMDpre) and percentage improvement (%Improve) effect sizes. Bayesian hierarchical meta-analysis models were conducted to compare effect sizes, develop prior distributions, and estimate 0.25-, 0.5-, and 0.75-quantiles to determine small, medium, and large thresholds, respectively. Data from 643 studies comprising 6574 effect sizes were included in the analyses. Large differences in distributions for both SMDpre and %Improve were identified across outcome domains (strength, power, jump and sprint performance), with analyses of the tails of the distributions indicating potential large overestimations of SMDpre values. Future evaluations of S&C training will be improved using Bayesian approaches featuring the information and priors developed in this study. To facilitate an uptake of Bayesian methods within S&C, an easily accessible tool employing intuitive Bayesian updating was created. It is recommended that the tool and specific thresholds be used instead of isolated effect size calculations and Cohen’s generic values when evaluating S&C training.