Meta-Analysis, Decision Analysis, and Cost-Effectiveness Analysis: Methods for Quantitative Synthesis in Medicine, Vol. 31 » (2nd Edition)

Petitti, Diana B., MD, MPH (Kaiser Permanente Southern California)

Meta-analysis, decision analysis, and cost-effectiveness analysis are the cornerstones of evidence-based medicine. These related quantitative methods have become essential tools in the formulation of clinical and public policy based on the synthesis of evidence. All three methods are taught with increasing frequency in medical schools and schools of public health and in health policy courses at the undergraduate and graduate level. This book is a lucid introduction, and will serve the needs of students taking introductory courses that cover these topics. It will also be useful to clinicians and policymakers who need to understand the quantitative underpinnings of the methods in order to best apply the information that derives from them. The second edition of this popular book adds new material on cumulative meta-analysis as a method to explore heterogeneity. The coverage of cost-effectiveness analysis has been brought into close alignment with recommendations of the U.S. Public Health Panel on Cost-Effectiveness Analysis in Health and Medicine. Many of the examples have been replaced with more current examples, and all of the material has been updated to reflect recent advances in the methods and the emergence of consensus about some previously controversial issues. analysis. These three closely related methods have become even more important for synthesizing research since the first edition was published in 1994. And they have gained legitimacy as tools for guiding health policy.

Patricia Langenberg

This book is a comprehensive review of meta-analysis, decision analysis, and cost-effectiveness analysis as quantitative methods for the synthesis of research information in medicine. The purpose is to describe methods of meta-analysis, decision analysis, and cost effectiveness analysis in order to summarize information from the literature in medicine. The objectives are particularly worthy in that the subjects are controversial and books on the topic have heretofore been primarily statistical or geared toward literature in fields other than medicine. The book is very well written and accessible to nearly anyone in the medical field who would contemplate either reading about or carrying out meta-analysis, decision analysis, or cost-effectiveness analysis. The author is highly knowledgeable about her subject. All stages of meta-analysis are covered: data retrieval/collection, detection of bias, statistical analysis, exploration of heterogeneity. Many relevant examples from the field of medicine are cited and examples of the statistical methods are provided. More important, space is devoted to the difficulties of identifying the 'fugitive' studies that may introduce serious bias (publication bias) if not included, since they are more likely to have negative results. Decision analysis methods are also described, including identification of the problem and its components structuring decision trees, estimation of probabilities, and sensitivity analysis. Decision analysis is described as the cornerstone of cost effectiveness analysis with the addition of cost data, identification of outcomes, and choice of cost-benefit function. This book is very well written, easy to understand andapply, with excellent relevant examples. It is the most comprehensive and accessible book in this field.

1. Introduction
2. Overview of the Methods
3. Planning the Study
4. Information Retrieval
5. Data Collection
6. Advanced Issues in Meta-Analysis
7. Statistical Methods in Meta-Analysis
8. Other Statistical Issues in Meta-Analysis
9. Complex Decision Problems
10. Estimating Probabilities
11. Utility Analysis
12. Advanced Cost Effectiveness Analysis
13. Utility and Cost-Utility Analysis
14. Exploring Heterogeneity
15. Sensitivity Analysis
16. Reporting Results
17. Limitations