Bmc Med Res Methodol
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Bmc Med Res Methodol · Jul 2016
Two new methods to fit models for network meta-analysis with random inconsistency effects.
Meta-analysis is a valuable tool for combining evidence from multiple studies. Network meta-analysis is becoming more widely used as a means to compare multiple treatments in the same analysis. However, a network meta-analysis may exhibit inconsistency, whereby the treatment effect estimates do not agree across all trial designs, even after taking between-study heterogeneity into account. We propose two new estimation methods for network meta-analysis models with random inconsistency effects. ⋯ The extent of heterogeneity and inconsistency should be assessed and reported in any network meta-analysis. Our two new methods can be used to fit models for network meta-analysis with random inconsistency effects. They are easily implemented using the accompanying R code in the Additional file 1. Using these estimation methods, the extent of inconsistency can be assessed and reported.
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Greater transparency and, in particular, sharing of clinical study reports and patient level data for further research is an increasingly important topic for the pharmaceutical and biotechnology industry and other organisations who sponsor and conduct clinical research as well as academic researchers and patient advocacy groups. Statisticians are ambassadors for data sharing and are central to its success. They play an integral role in data sharing discussions within their companies and also externally helping to shape policy and processes while providing input into practical solutions to aid data sharing. Data sharing is generating changes in the required profile for statisticians in the pharmaceutical and biotechnology industry, as well as academic institutions and patient advocacy groups. ⋯ Successful statisticians need to possess many qualities required in today's pharmaceutical environment such as collaboration, diplomacy, written and oral skills and an ability to be responsive; they are also knowledgeable when debating strategy and analytical techniques. However, increasing data transparency will require statisticians to evolve and learn new skills and behaviours during their career which may not have been an accepted part of the traditional role. Statisticians will move from being the gate-keepers of data to be data facilitators. To adapt successfully to this new environment, the role of the statistician is likely to be broader, including defining new responsibilities that lie beyond the boundaries of the traditional role. Statisticians should understand how data transparency can benefit them and the potential strategic advantage it can bring and be fully aware of the pharmaceutical and biotechnology industry commitments to data transparency and the policies within their company or research institute in addition to focusing on reviewing requests and provisioning data. Data transparency will evolve the role of statisticians within the pharmaceutical and biotechnology industry, academia and research bodies to a level which may not have been an accepted part of their traditional role or career. In the future, skills will be required to manage challenges arising from data sharing; statisticians will need strong scientific and statistical guiding principles for reanalysis and supplementary analyses based on researchers' requests, have enhanced consultancy skills, in particular the ability to defend good statistical practice in the face of criticism and the ability to critique methods of analysis. Statisticians will also require expertise in data privacy regulations, data redaction and anonymisation and be able to assess the probability of re-identification, an ability to understand analyses conducted by researchers and recognise why such analyses may propose different results compared to the original analyses. Bringing these skills to the implementation of data sharing and interpretation of the results will help to maximise the value of shared data while guarding against misleading conclusions.
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Bmc Med Res Methodol · Jul 2016
LetterProtecting patient privacy when sharing patient-level data from clinical trials.
Greater transparency and, in particular, sharing of patient-level data for further scientific research is an increasingly important topic for the pharmaceutical industry and other organisations who sponsor and conduct clinical trials as well as generally in the interests of patients participating in studies. A concern remains, however, over how to appropriately prepare and share clinical trial data with third party researchers, whilst maintaining patient confidentiality. Clinical trial datasets contain very detailed information on each participant. Risk to patient privacy can be mitigated by data reduction techniques. However, retention of data utility is important in order to allow meaningful scientific research. In addition, for clinical trial data, an excessive application of such techniques may pose a public health risk if misleading results are produced. After considering existing guidance, this article makes recommendations with the aim of promoting an approach that balances data utility and privacy risk and is applicable across clinical trial data holders. ⋯ Our key recommendations are as follows: 1. Data anonymisation/de-identification: Data holders are responsible for generating de-identified datasets which are intended to offer increased protection for patient privacy through masking or generalisation of direct and some indirect identifiers. 2. Controlled access to data, including use of a data sharing agreement: A legally binding data sharing agreement should be in place, including agreements not to download or further share data and not to attempt to seek to identify patients. Appropriate levels of security should be used for transferring data or providing access; one solution is use of a secure 'locked box' system which provides additional safeguards. This article provides recommendations on best practices to de-identify/anonymise clinical trial data for sharing with third-party researchers, as well as controlled access to data and data sharing agreements. The recommendations are applicable to all clinical trial data holders. Further work will be needed to identify and evaluate competing possibilities as regulations, attitudes to risk and technologies evolve.
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Bmc Med Res Methodol · Jul 2016
LetterEFSPI/PSI working group on data sharing: accessing and working with pharmaceutical clinical trial patient level datasets - a primer for academic researchers.
Access to patient level datasets from clinical trial sponsors continues to be an important topic for the Pharmaceutical Industry as well as academic institutions and researchers. How to make access to patient level data actually happen raises many questions from the perspective of the researcher. ⋯ Whilst the benefits and value of patient level data sharing have yet to be fully realised, we hope that the information outlined in this article will encourage researchers to consider accessing and re-using clinical trial data to support their research questions.
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Greater transparency, including sharing of patient-level data for further research, is an increasingly important topic for organisations who sponsor, fund and conduct clinical trials. This is a major paradigm shift with the aim of maximising the value of patient-level data from clinical trials for the benefit of future patients and society. We consider the analysis of shared clinical trial data in three broad categories: (1) reanalysis - further investigation of the efficacy and safety of the randomized intervention, (2) meta-analysis, and (3) supplemental analysis for a research question that is not directly assessing the randomized intervention. ⋯ In order to support appropriate interpretation and limit the risk of misleading findings, analysis of shared clinical trial data should have a pre-specified analysis plan. However, it is not generally possible to limit bias and control multiplicity to the extent that is possible in the original trial design, conduct and analysis, and this should be acknowledged and taken into account when interpreting results. We highlight a number of areas where specific considerations arise in planning, conducting, interpreting and reporting analyses of shared clinical trial data. A key issue is that that these analyses essentially share many of the limitations of any post hoc analyses beyond the original specified analyses. The use of individual patient data in meta-analysis can provide increased precision and reduce bias. Supplemental analyses are subject to many of the same issues that arise in broader epidemiological analyses. Specific discussion topics are addressed within each of these areas. Increased provision of patient-level data from industry and academic-led clinical trials for secondary research can benefit future patients and society. Responsible data sharing, including transparency of the research objectives, analysis plans and of the results will support appropriate interpretation and help to address the risk of misleading results and avoid unfounded health scares.