Meta-CART: A tool to identify interactions between moderators in meta-analysis

Br J Math Stat Psychol. 2017 Feb;70(1):118-136. doi: 10.1111/bmsp.12088.

Abstract

In the framework of meta-analysis, moderator analysis is usually performed only univariately. When several study characteristics are available that may account for treatment effect, standard meta-regression has difficulties in identifying interactions between them. To overcome this problem, meta-CART has been proposed: an approach that applies classification and regression trees (CART) to identify interactions, and then subgroup meta-analysis to test the significance of moderator effects. The previous version of meta-CART has its shortcomings: when applying CART, the sample sizes of studies are not taken into account, and the effect sizes are dichotomized around the median value. Therefore, this article proposes new meta-CART extensions, weighting study effect sizes by their accuracy, and using a regression tree to avoid dichotomization. In addition, new pruning rules are proposed. The performance of all versions of meta-CART was evaluated via a Monte Carlo simulation study. The simulation results revealed that meta-regression trees with random-effects weights and a 0.5-standard-error pruning rule perform best. The required sample size for meta-CART to achieve satisfactory performance depends on the number of study characteristics, the magnitude of the interactions, and the residual heterogeneity.

Keywords: classification and regression trees; interaction between moderators; meta-analysis; residual heterogeneity; weighted effect sizes.

MeSH terms

  • Algorithms*
  • Computer Simulation
  • Data Interpretation, Statistical
  • Meta-Analysis as Topic*
  • Models, Statistical*
  • Outcome Assessment, Health Care / methods*
  • Regression Analysis*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Software*