脑脊液分流术限制性平均生存时间（RMST）Meta分析方法学正确性咨询

研究背景与操作步骤 #

针对脑积水的脑脊液分流术开展**限制性平均生存时间（RMST）**单均数Meta分析，操作流程如下：

• 对已发表的生存曲线进行数字化处理
• 借助R包IPDfromKM提取个体患者数据
• 重建生存曲线并计算12个月RMST

已获取的研究数据 #

study <- c("study1", "study2", "study3", "study4", "study5")
n_patients <- c(535, 209, 111, 599, 434)
rmst_12 <- c(10.54759, 11.36175, 10.50244, 10.51183, 8.716552)
se_12 <- c(0.1463532, 0.1439506, 0.3246873, 0.1471398, 0.2374582)

# 数据框预览
> data
   study n_patients  rmst_12     se_12
1 study1        535 10.54759 0.1463532
2 study2        209 11.36175 0.1439506
3 study3        111 10.50244 0.3246873
4 study4        599 10.51183 0.1471398
5 study5        434 8.716552 0.2374582

Meta分析实施代码与结果 #

# 从标准误(SE)计算标准差(SD)
data$sd_12 <- data$se_12 * sqrt(data$n_patients)

# 加载meta包
require(meta)

# 用metamean函数开展Meta分析
mm_12 <- metamean(n = n_shunts,
                  mean = rmst_12,
                  sd = sd_12,
                  studlab = author_year, 
                  data = data, 
                  method.mean = "Luo",
                  method.sd = "Shi",
                  sm = 'MRAW',             
                  random = TRUE,          
                  warn = TRUE,
                  prediction = TRUE,
                  method.tau = "REML")

# 分析结果
> mm_12
Number of studies combined: k = 5
Number of observations: o = 1888

                        mean             95%-CI
Common effect model  10.5757 [10.4247; 10.7268]
Random effects model 10.3373 [ 9.4868; 11.1878]
Prediction interval          [ 7.0212; 13.6534]

Quantifying heterogeneity:
 tau^2 = 0.8975 [0.2937; 7.7528]; tau = 0.9474 [0.5419; 2.7844]
 I^2 = 95.6% [92.3%; 97.5%]; H = 4.78 [3.61; 6.34]

Test of heterogeneity:
     Q d.f.  p-value
 91.39    4 < 0.0001

Details on meta-analytical method:
- Inverse variance method
- Restricted maximum-likelihood estimator for tau^2
- Q-Profile method for confidence interval of tau^2 and tau
- Prediction interval based on t-distribution (df = 3)
- Untransformed (raw) means

疑问 #

分析过程无报错，但不确定上述操作在方法学层面是否正确，恳请专业人士给予指导。

内容的提问来源于stack exchange，提问作者CharlesLDN