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Meta Analysis of Survival Benefit of Radiotherapy

Question

We will be conducting a meta-analysis to investigate whether surgery (cystectomy) combined with radiotherapy has a survival benefit (measured at 3-years) compared to radiotherapy alone for patients with bladder cancer.

  • Conduct a keyword search in (ovid) Medline (untick “Map Term to Subject Heading”) using the following search terms:

Bladder carcinoma

Radical radiotherapy

Preoperative radiotherapy

Radical cystectomy

Controlled trial

 

Combine these with an ‘and’ command. Present your search results in a table showing the number of studies found at each step.

  • Your search above should have found one study only. Extract the data from this study to be included in the meta-analysis. Hint: we want to look at 3 year survival comparing the two arms of the trial.
  • There were two other studies found that investigate three year survival, their results are shown in the following table:

Table1: Extracted data from two studies found via other searches

3 year survival                                                Cystectomy                 Radiotherapy

                                                            Survived          Total    Survived          Total

Miller 1977                                              18                    35        7                      32

Sell 1991                                                 39                    88        31                    95

Calculate the study specific odds ratios comparing survival for cystectomy with survival for radiotherapy. Then calculate the Mantel-Haenszel pooled odds ratio.

  • Further analysis finds an I-squared = 0.0%. Is your analysis in part c) appropriate?
  • Interpret your pooled odds ratio from part c). A test was conducted to see if the pooled odds ratio is significantly different form 1 and this test has a p-value = 0.0011, use this information to help with your interpretation.

Summary

This question belongs to statistics and discusses about a meta-analysis to investigate whether surgery (cystectomy) combined with radiotherapy has a survival benefit (measured at 3-years) compared to radiotherapy alone for patients with bladder cancer.

Word count: 441

 

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