The value of the aggregate data approach in meta-analysis with time-to-event outcomes

Collecting individual patient data has been described as the 'gold standard' for undertaking meta-analysis. If studies involve time-to-event outcomes, conducting a meta-analysis based on aggregate data can be problematical. Two meta-analyses of randomized controlled trials with time-to-event outcomes are used to illustrate the practicality and value of several proposed methods to obtain summary statistic estimates. In the first example the results suggest that further effort should be made to find unpublished trials. In the second example the use of aggregate data for trials where no individual patient data have been supplied allows the totality of evidence to be assessed and indicates previously unrecognized heterogeneity.