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York academics develop enhanced health meta-analysis tool

Posted on 4 December 2015

Health economists at the University of York have developed a simple extension to meta-analysis, used to estimate the health benefits of further research and changes to clinical practice.

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Decisions about funding different research studies in healthcare intervention, and at what point evidence should be implemented, are important considerations in conducting research and changing health policy. Meta-analysis can assist in this process.

A standard statistical tool, extended by academics in the Centre for Health Economics (CHE) at York, combines results from a number of studies to provide a single pooled result. This result of standard meta-analysis is extended to assess the potential health benefits of gathering additional evidence and implementing findings, in a way that cannot be achieved by examining statistical significance alone.

Combining the estimated relative measure of effect on health, such as the odds ratio for mortality, with estimates of baseline risk and incidence of ill-health, this new tool estimates the health gains of efforts to reduce uncertainty in the health consequences of treatment.

Ensuring the findings of existing research are better adopted within clinical practice can also improve health outcomes. Using the enhanced meta-analysis tool, an estimate of relative health effects is combined with figures of baseline ill-health risk and incidence, allowing an estimation of the expected health benefits of implementing research findings.

To illustrate how the potential benefits of further research versus implementing current research findings can evolve, York researchers used clinical trials that investigated a treatment for blood clots (thrombolysis) using an enzyme based drug (streptokinase) after a heart attack. Here, the expected benefits of implementing findings of existing research quickly exceeded the potential benefits of further research.

Early implementation of new interventions, based on the balance of evidence, might not always be appropriate however if their widespread use means that further research becomes impossible or more costly. In these cases, it may be better to delay implementing research findings until the benefits of further research are secured.

Professor Karl Claxton, Professor of Economics in CHE, said: “These methods could be routinely used to identify which research is likely to make the biggest difference to health outcomes in the longer run. It tells us something about whether we could make a bigger difference to NHS patients by spending more on health research.

“It can also help decide whether it is better to encourage the early use of a new drug or whether more patients would benefit to a greater extent by waiting until more research is done.”

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