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Title: Application of credibility ceilings probes the robustness of meta-Analyses of biomarkers and cancer risk
Authors: Papatheodorou, Stefania 
Tsilidis, Konstantinos K. 
Ioannidis, John P. A. 
Evangelou, Evangelos 
Keywords: Biomarkers
Credibility ceiling
Predictive intervals
Issue Date: 1-Feb-2015
Publisher: Elsevier B.V.
Source: Journal of Clinical Epidemiology, 2015, Volume 68, Issue 2, Pages 163-174
Abstract: Objectives Meta-Analyses of biomarkers often present spurious significant results and large effects. We applied sensitivity analyses with the use of credibility ceilings to assess whether and how the results of meta-Analyses of biomarkers and cancer risk would change. Study Design and Setting We evaluated 98 meta-Analyses, 43 (44%) of which had nominally statistically significant results. We assumed that any single study cannot give more than a maximum certainty 100 - c% (c, credibility ceiling) that the effect estimate [odds ratio (OR)] exceeds 1 (null) or 1.2. Results Nominal statistical significance was maintained for 21 (21%) meta-Analyses, for c = 10% and OR >1, and these proportions changed to 7%, 3%, and 6% with ceilings of 20%, 30%, and 40%, respectively. For ceilings for OR >1.2, the respective proportions were 37%, 21%, 7%, and 3%. Seven meta-Analyses on infectious agents retained statistical significance even with a high ceiling of c = 20% for OR >1.00. Meta-Analyses without other hints of bias (large between-study heterogeneity, small-study effects, excess significance) were more likely to retain statistical significance than those that had such hints of bias. Conclusion Credibility ceilings may be helpful in meta-Analyses of biomarkers to understand the robustness of the results to different levels of uncertainty.
ISSN: 0895-4356
DOI: 10.1016/j.jclinepi.2014.09.004
Rights: © Elsevier Inc.
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