Meta-analysis of repeated measures study designs

Rationale, aims and objectives Repeated measures studies are found in many areas of research, particularly in areas of healthcare. There is currently little information available to inform the method of meta-analysis of repeated measures studies so that the structural dependence of the data is appropriately accommodated and the findings are meaningful. Method Using a published meta-analysis on the impact of diet advice on weight reduction of obese or overweight individuals, we demonstrate possible approaches for repeated measures meta-analysis. These approaches differ in terms of the type of result obtained (e.g. effect at a particular time-point, trend over time, change between time-points) and the data needed for the analysis (e.g. means, regression slope estimates). Some approaches involve violating assumptions of independence in the data structure and so to investigate the impact of this violation a simulation study is carried out. Results The different approaches described for the meta-analyses of repeated measures studies can all provide useful effect estimates depending on the question to be addressed by the meta-analysis. However, violation of the independence assumption in some approaches can lead to biased estimates. Conclusions In practice, the methods available to carry out meta-analyses of repeated measures studies will not only depend upon the question of interest, but also on the data available from the primary studies.