Meta-analysis of interrupted time series designs: what is the effect size?

2001 ◽  
Vol 1 (S3) ◽  
Author(s):  
Craig Ramsay ◽  
Jeremy Grimshaw ◽  
Roberto Grilli
2018 ◽  
Author(s):  
Kevin Tarlow ◽  
Daniel Brossart

Single-case experimental methods are used across a range of educational and psychological research. Single-case data are analyzed with a variety of methods, but no statistic has demonstrated clear superiority over other methods. The time-series nature of single-case designs requires special consideration for baseline trend and autocorrelation when estimating intervention effect size. However, standard correction methods are limited because they assume precise statistical estimation of trend and autocorrelation. Unlike standard correction methods, Monte Carlo simulation methods can address the poor precision of single-case effect size indices. This paper presents the rationale for a new simulation method, Interrupted Time-Series Simulation (ITSSIM). A small field test was also conducted, and ITSSIM performed similarly to sophisticated multilevel methods for single-case research. ITSSIM is accessible as a free software application that requires no prior knowledge of statistical computing or syntax. ITSSIM may be used to estimate the effect size of a single interrupted time-series (AB design), and multiple ITSSIM effect size estimates may be combined via meta-analysis.


F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 110
Author(s):  
Elizabeth Korevaar ◽  
Amalia Karahalios ◽  
Andrew B. Forbes ◽  
Simon L. Turner ◽  
Steve McDonald ◽  
...  

Background: Systematic reviews are used to inform healthcare decision making. In reviews that aim to examine the effects of organisational, policy change or public health interventions, or exposures, evidence from interrupted time series (ITS) studies may be included. A core component of many systematic reviews is meta-analysis, which is the statistical synthesis of results across studies. There is currently a lack of guidance informing the choice of meta-analysis methods for combining results from ITS studies, and there have been no studies examining the meta-analysis methods used in practice. This study therefore aims to describe current meta-analysis methods used in a cohort of reviews of ITS studies. Methods: We will identify the 100 most recent reviews (published between 1 January 2000 and 11 October 2019) that include meta-analyses of ITS studies from a search of eight electronic databases covering several disciplines (public health, psychology, education, economics). Study selection will be undertaken independently by two authors. Data extraction will be undertaken by one author, and for a random sample of the reviews, two authors. From eligible reviews we will extract details at the review level including discipline, type of interruption and any tools used to assess the risk of bias / methodological quality of included ITS studies; at the meta-analytic level we will extract type of outcome, effect measure(s), meta-analytic methods, and any methods used to re-analyse the individual ITS studies. Descriptive statistics will be used to summarise the data. Conclusions: This review will describe the methods used to meta-analyse results from ITS studies. Results from this review will inform future methods research examining how different meta-analysis methods perform, and ultimately, the development of guidance.


Thorax ◽  
2021 ◽  
pp. thoraxjnl-2020-216380
Author(s):  
Gwyneth A Davies ◽  
Mohammad A Alsallakh ◽  
Shanya Sivakumaran ◽  
Eleftheria Vasileiou ◽  
Ronan A Lyons ◽  
...  

BackgroundThe COVID-19 pandemic’s impact on people with asthma is poorly understood. We hypothesised that lockdown restrictions were associated with reductions in severe asthma exacerbations requiring emergency asthma admissions and/or leading to death.MethodsUsing data from Public Health Scotland and the Secure Anonymised Information Linkage Databank in Wales, we compared weekly counts of emergency admissions and deaths due to asthma over the first 18 weeks in 2020 with the national averages over 2015–2019. We modelled the impact of instigating lockdown on these outcomes using interrupted time-series analysis. Using fixed-effect meta-analysis, we derived pooled estimates of the overall changes in trends across the two nations. We also investigated trends in asthma-related primary care prescribing and emergency department (ED) attendances in Wales.ResultsLockdown was associated with a 36% pooled reduction in emergency admissions for asthma (incidence rate ratio, IRR: 0.64, 95% CI: 0.49 to 0.83, p value 0.001) across both countries. There was no significant change in asthma deaths (pooled IRR: 0.57, 95% CI: 0.17 to 1.94, p value 0.37). ED asthma attendances in Wales declined during lockdown (IRR: 0.85, 95% CI: 0.73 to 0.99, p value 0.03). A large spike of 121% more inhaled corticosteroids and 133% more oral corticosteroid prescriptions was seen in Wales in the week before lockdown.ConclusionsNational lockdowns were associated with substantial reductions in severe asthma exacerbations leading to hospital admission across both Scotland and Wales, with no corresponding increase in asthma deaths.


F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 110
Author(s):  
Elizabeth Korevaar ◽  
Amalia Karahalios ◽  
Andrew B. Forbes ◽  
Simon L. Turner ◽  
Steve McDonald ◽  
...  

Background: Systematic reviews are used to inform healthcare decision making. In reviews that aim to examine the effects of organisational, policy change or public health interventions, or exposures, evidence from interrupted time series (ITS) studies may be included. A core component of many systematic reviews is meta-analysis, which is the statistical synthesis of results across studies. There is currently a lack of guidance informing the choice of meta-analysis methods for combining results from ITS studies, and there have been no studies examining the meta-analysis methods used in practice. This study therefore aims to describe current meta-analysis methods used in a cohort of reviews of ITS studies. Methods: We will identify the 100 most recent reviews (published between 1 January 2000 and 11 October 2019) that include meta-analyses of ITS studies from a search of eight electronic databases covering several disciplines (public health, psychology, education, economics). Study selection will be undertaken independently by two authors. Data extraction will be undertaken by one author, and for a random sample of the reviews, two authors. From eligible reviews we will extract details at the review level including discipline, type of interruption and any tools used to assess the risk of bias / methodological quality of included ITS studies; at the meta-analytic level we will extract type of outcome, effect measure(s), meta-analytic methods, and any methods used to re-analyse the individual ITS studies. Descriptive statistics will be used to summarise the data. Conclusions: This review will describe the methods used to meta-analyse results from ITS studies. Results from this review will inform future methods research examining how different meta-analysis methods perform, and ultimately, the development of guidance.


F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 110
Author(s):  
Elizabeth Korevaar ◽  
Amalia Karahalios ◽  
Andrew B. Forbes ◽  
Simon L. Turner ◽  
Steve McDonald ◽  
...  

Background: Systematic reviews are used to inform healthcare decision making. In reviews that aim to examine the effects of organisational, policy change or public health interventions, or exposures, evidence from interrupted time series (ITS) studies may be included. A core component of many systematic reviews is meta-analysis, which is the statistical synthesis of results across studies. There is currently a lack of guidance informing the choice of meta-analysis methods for combining results from ITS studies, and there have been no studies examining the meta-analysis methods used in practice. This study therefore aims to describe current meta-analysis methods used in a cohort of reviews of ITS studies. Methods: We will identify 100 reviews that include meta-analyses of ITS studies from a search of eight electronic databases covering several disciplines (public health, psychology, education, economics). Study selection will be undertaken independently by two authors. Data extraction will be undertaken by one author, and for a random sample of the reviews, two authors. From eligible reviews we will extract details at the review level including discipline and type of interruption; at the meta-analytic level we will extract type of outcome, effect measure(s), meta-analytic methods, and any methods used to re-analyse the individual ITS studies. Descriptive statistics will be used to summarise the data. Conclusions: This review will describe the methods used to meta-analyse results from ITS studies. Results from this review will inform future methods research examining how different meta-analysis methods perform, and ultimately, the development of guidance.


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