With the rapidly growing literature across the surgical disciplines, there is a corresponding need to critically appraise and summarize the currently available evidence so they can be applied appropriately to patient care. The interpretation of systematic reviews is particularly challenging in cases where few robust clinical trials have been performed to address a particular question. However, risk of bias can be minimized and potentially useful conclusions can be drawn if strict review methodology is adhered to, including an exhaustive literature search, quality appraisal of primary studies, appropriate statistical methodology, assessment of confidence in estimates and risk of bias. Therefore, the following article aims to: (Ⅰ) summarize to the important features of a thorough and rigorous systematic review or meta-analysis for the surgical literature; (Ⅱ) highlight several underused statistical approaches which may yield further interesting insights compared to conventional pair-wise data synthesis techniques; and (Ⅲ) propose a guide for thorough analysis and presentation of results.
The paper presents two statistical methods to compare summary estimates of different subgroups in meta-analysis. It also shows how to use Z test and meta-regression model with dichotomous data and continuous data in R software to explain the similarities and differences between the two statistical methods by examples.
The R software bmeta package is a package that implements Bayesian meta-analysis and meta-regression by invoking JAGS software. The program is based on the Markov Chain Monte Carlo (MCMC) algorithm to combine various effect quantities (OR, MD and IRR) of different types of data (dichotomies, continuities and counts). The package has the advantages of fewer command function parameters, rich models, powerful drawing function, easy of understanding and mastering. In this paper, an example is presented to demonstrate the complete operation flow of bmeta package to implement bayesian meta-analysis and meta-regression.