The following is a summary of “Exploring the fragility of meta-analyses in ophthalmology: a systematic review,” published in the July 2024 issue of Ophthalmology by Nanji et al.
The fragility index (FI) assesses how altering event statuses in trials can affect the statistical significance of meta-analysis results, enhancing their interpretation and informing clinical practice changes.
Researchers conducted a retrospective study assessing the fragility of meta-analyses in ophthalmology.
They focused on meta-analyses of RCTs with binary outcomes, published in journals classified as ‘Ophthalmology’ by the Journal Citation Report or in Ophthalmology-related Cochrane Reviews. The FI for each meta-analysis was determined through an iterative process. Multivariable linear regression modeling evaluated the relationship between the FI and potential predictive factors in statistically significant and non-significant meta-analyses.
The result showed 175 meta-analyses, with a median FI of 6 (Q1–Q3: 3–12), indicating that altering the outcomes of 6 participants would change the results. The FI was 1 for 18 (10.2%) of the meta-analyses and was ≤5 for 75 (42.4%) meta-analyses. The number of events (P<0.001) and the P-value (P< 0.001) emerged as the strongest predictors of the FI in both significant and non-significant meta-analyses.
Investigators concluded that the fragility of meta-analyses in ophthalmology was primarily influenced by the number of events and P-value, with the FI as a clear indicator of the evidence’s robustness.
Source: link.springer.com/article/10.1038/s41433-024-03255-2
