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Statistical model assessment in published dose-response meta-analyses is suboptimal: evidence from a methodological review and reanalysis of 242 datasets

2025· article· en· W4414422261 on OpenAlexafffund
Marimuthu Sappani, Shofiqul Islam, Joseph Beyene

Bibliographic record

VenueJournal of Clinical Epidemiology · 2025
Typearticle
Languageen
FieldDecision Sciences
TopicMeta-analysis and systematic reviews
Canadian institutionsHamilton Health SciencesPopulation Health Research InstituteMcMaster UniversityImpact
FundersMcMaster University
KeywordsCredibilityStatistical modelSelection (genetic algorithm)Statistical analysisModel selectionKey (lock)Statistical hypothesis testing

Abstract

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OBJECTIVES: Dose-response meta-analysis (DRMA) is a crucial clinical and epidemiological research tool for synthesizing exposure-risk relationships. Despite its growing use, facilitated by the availability of statistical software, the appropriateness of the underlying statistical methods has not been thoroughly explored. This study aims to evaluate the reporting quality of key statistical measures in DRMA and compare their performance using empirical datasets. STUDY DESIGN AND SETTING: We performed a systematic literature search to identify relevant studies, from which we extracted datasets and study characteristics. We fitted linear, quadratic polynomial and restricted cubic spline (RCS) models with fixed and non-fixed knots selection procedures. Key measures assessed included non-linearity, goodness-of-fit (GoF), model comparison, and the impact of outlying studies on statistical results. We compared P-values for non-linearity, GoF test for each model pair, and used the Akaike information criterion for model comparison. We evaluated the influence of individual studies on non-linearity and GoF using a leave-one-out (LOO) approach. RESULTS: We included 146 unique DRMA studies, from which 242 datasets were extracted with median (interquartile range) of 9 (7, 14) individual studies. While the non-linearity test was conducted in 102/124 (82.3%) studies, other measures were infrequently reported. Only 13/146 (10.0%) studies assessed GoF, 10/79 (12.7%) provided model comparison results, and 46/146 (31.5%) examined the impact of outlying studies. Our reanalysis of 242 datasets demonstrated that the RCS model with a non-fixed knots selection procedure identified more non-linearity (110/242, 45.5%) and fitted well (205/242, 84.7%) than other models. The LOO approach showed that conclusions regarding non-linearity and GoF changed in approximately 50% of cases after excluding a single study, regardless of the model used. CONCLUSION: Our analysis reveals suboptimal attention to key statistical issues in published DRMA studies. RCS with non-fixed knots selection have shown potential advantages than a few other alternative modeling approaches. To strengthen the credibility of meta-analytic findings, it is advisable for researchers to integrate both clinical judgment and rigorous statistical model evaluation in their analyses. The LOO assessment underscores the necessity for methods that can identify and accommodate outlying studies in DRMA.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.379
metaresearch head score (Gemma)0.706
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch, Meta-epidemiology (broad)
Consensus categoriesMetaresearch
DomainCandidate signal: Methods · Consensus signal: none
Study designCandidate signal: Systematic review · Consensus signal: Systematic review
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.987
Threshold uncertainty score0.765

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.3790.706
Meta-epidemiology (narrow)0.0040.003
Meta-epidemiology (broad)0.0130.040
Bibliometrics0.0170.021
Science and technology studies0.0020.004
Scholarly communication0.0110.007
Open science0.0070.006
Research integrity0.0040.004
Insufficient payload (model declined to judge)0.0060.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.986
GPT teacher head0.795
Teacher spread0.191 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; the direct Gemma label and the distilled Codex classifier agree on what is shown here.

Study designSystematic review
DomainMethods
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations2
Published2025
Admission routes2
Has abstractyes

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