Meta-analyses and Forest plots using a microsoft excel spreadsheet: step-by-step guide focusing on descriptive data analysis

Neyeloff, Jeruza Lavanholi; Fuchs, Sandra Cristina Pereira Costa; Moreira, Leila Beltrami

doi:10.1186/1756-0500-5-52

Cited by 586 publications

(445 citation statements)

References 7 publications

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“…A random-effects model with inverse variance weighting was used to analyze the data. All calculations for the meta-analysis, as well as any construction of forest plots, were accomplished using a previously published spreadsheet by Neyeloff et al 42 The principal summary measure consisted of the effect summary mean and the 95% CIs. Due to the lack of control groups in the 32 included studies, there was no calculation of relative risk ratios.…”

Section: Resultsmentioning

confidence: 99%

Comparison of clinical outcomes in decompression and fusion versus decompression only in patients with ossification of the posterior longitudinal ligament: a meta-analysis

Mehdi

Alentado

Lee

et al. 2016

FOC

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OBJECTIVE Ossification of the posterior longitudinal ligament (OPLL) is a pathological calcification or ossification of the PLL, predominantly occurring in the cervical spine. Although surgery is often necessary for patients with symptomatic neurological deterioration, there remains controversy with regard to the optimal surgical treatment. In this systematic review and meta-analysis, the authors identified differences in complications and outcomes after anterior or posterior decompression and fusion versus after decompression alone for the treatment of cervical myelopathy due to OPLL. METHODS A MEDLINE, SCOPUS, and Web of Science search was performed for studies reporting complications and outcomes after decompression and fusion or after decompression alone for patients with OPLL. A meta-analysis was performed to calculate effect summary mean values, 95% CIs, Q statistics, and I2 values. Forest plots were constructed for each analysis group. RESULTS Of the 2630 retrieved articles, 32 met the inclusion criteria. There was no statistically significant difference in the incidence of excellent and good outcomes and of fair and poor outcomes between the decompression and fusion and the decompression-only cohorts. However, the decompression and fusion cohort had a statistically significantly higher recovery rate (63.2% vs 53.9%; p < 0.0001), a higher final Japanese Orthopaedic Association score (14.0 vs 13.5; p < 0.0001), and a lower incidence of OPLL progression (< 1% vs 6.3%; p < 0.0001) compared with the decompression-only cohort. There was no statistically significant difference in the incidence of complications between the 2 cohorts. CONCLUSIONS This study represents the only comprehensive review of outcomes and complications after decompression and fusion or after decompression alone for OPLL across a heterogeneous group of surgeons and patients. Based on these results, decompression and fusion is a superior surgical technique compared with posterior decompression alone in patients with OPLL. These results indicate that surgical decompression and fusion lead to a faster recovery, improved postoperative neurological functioning, and a lower incidence of OPLL progression compared with posterior decompression only. Furthermore, decompression and fusion did not lead to a greater incidence of complications compared with posterior decompression only.

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Section: Resultsmentioning

confidence: 99%

Comparison of clinical outcomes in decompression and fusion versus decompression only in patients with ossification of the posterior longitudinal ligament: a meta-analysis

Mehdi

Alentado

Lee

et al. 2016

FOC

View full text Add to dashboard Cite

show abstract

“…Calculations for the meta-analysis and construction of forest plots were completed using an established spreadsheet by Neyeloff et al 40 The principal summary measures were the effect summary values and 95% CIs. The presence of zero complication events in some studies did not permit calculations.…”

Section: Resultsmentioning

confidence: 99%

Lumbar microdiscectomy complication rates: a systematic review and meta-analysis

Shriver¹,

Xie

Tye³

et al. 2015

FOC

117

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OBJECT Lumbar microdiscectomy and its various minimally invasive surgical techniques are seeing increasing popularity, but a systematic review of their associated complications has yet to be performed. The authors sought to identify all prospective clinical studies reporting complications associated with lumbar open microdiscectomy, microendoscopic discectomy (MED), and percutaneous microdiscectomy. METHODS The authors conducted MEDLINE, Scopus, Web of Science, and Embase database searches for randomized controlled trials and prospective cohort studies reporting complications associated with open, microendoscopic, or percutaneous lumbar microdiscectomy. Studies with fewer than 10 patients and published before 1990 were excluded. Overall and interstudy median complication rates were calculated for each surgical technique. The authors also performed a meta-analysis of the reported complications to assess statistical significance across the various surgical techniques. RESULTS Of 9504 articles retrieved from the databases, 42 met inclusion criteria. Most studies screened were retrospective case series, limiting the number of studies that could be included. A total of 9 complication types were identified in the included studies, and these were analyzed across each of the surgical techniques. The rates of any complication across the included studies were 12.5%, 13.3%, and 10.8% for open, MED, and percutaneous microdiscectomy, respectively. New or worsening neurological deficit arose in 1.3%, 3.0%, and 1.6% of patients, while direct nerve root injury occurred at rates of 2.6%, 0.9%, and 1.1%, respectively. Hematoma was reported at rates of 0.5%, 1.2%, and 0.6%, respectively. Wound complications (infection, dehiscence, orseroma) occurred at rates of 2.1%, 1.2%, and 0.5%, respectively. The rates of recurrent disc complications were 4.4%, 3.1%, and 3.9%, while reoperation was indicated in 7.1%, 3.7%, and 10.2% of operations, respectively. Meta-analysis calculations revealed a statistically significant higher rate of intraoperative nerve root injury following percutaneous procedures relative to MED. No other significant differences were found. CONCLUSIONS This review highlights complication rates among various microdiscectomy techniques, which likely reflect real-world practice and conceptualization of complications among physicians. This investigation sets the framework for further discussions regarding microdiscectomy options and their associated complications during the informed consent process.

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“…Meta-analysis of the CFRs of historic outbreaks and proportion of fatal cases (PFC) of current outbreaks was carried out on all cases due to ZEBOV to date using the random effects model [28]. All available data from the World Health Organization (WHO) website as submitted by the health authorities of affected countries [6,29,30] were collected.…”

Section: Methodsologymentioning

confidence: 99%

Descriptive analyses and risk of death due to Ebola Virus Disease, West Africa, 2014

Fasina

Adenubi

Ogundare

et al. 2015

J Infect Dev Ctries

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Introduction: Since the first case of Ebola virus disease (EVD) in Guinea in 2013, major outbreaks have been reported in West Africa. Methodology: Cases and fatalities of EVD caused by Zaire Ebola virus (ZEBOV) were evaluated, and the risks of dying in the general population and in healthcare workers were assessed. Results: The case fatality rate estimated for EVD was 76.4% in 20 studies. Cumulative proportion of fatal cases in West Africa was 42.9%, 30.1%, and 64.2% in Liberia, Sierra Leone, and Guinea, respectively. The proportion of total deaths in Liberia, Sierra Leone, and Guinea was 42.5%, 35.8%, and 21.6%, respectively. Healthcare workers were at higher risk of dying compared with the general public, and the same applied to intense transmission countries and to countries with sufficient bed capacities. The declaration of a health emergency "out-ofcontrol" situation by the World Health Organization on 8 August 2014 reduced the risk of death among patients. Factors including deplorable healthcare delivery infrastructure in war-ravaged regions of Africa, the impotence of governments to enforce public health regulations, and the loss of confidence in public healthcare delivery programs were key among others factors that enhanced the spread and magnitude of outbreaks. Conclusions: The findings underscore the need for an overall re-appraisal of the healthcare systems in African countries and the ability to cope with widespread epidemic challenges. Outbreaks like that of Ebola diseases should be handled not just as a medical emergency but also a socio-economic problem with significant negative economic impacts.

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Meta-analyses and Forest plots using a microsoft excel spreadsheet: step-by-step guide focusing on descriptive data analysis

Cited by 586 publications

References 7 publications

Comparison of clinical outcomes in decompression and fusion versus decompression only in patients with ossification of the posterior longitudinal ligament: a meta-analysis

Comparison of clinical outcomes in decompression and fusion versus decompression only in patients with ossification of the posterior longitudinal ligament: a meta-analysis

Lumbar microdiscectomy complication rates: a systematic review and meta-analysis

Descriptive analyses and risk of death due to Ebola Virus Disease, West Africa, 2014

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