American Journal of Epidemiology Advance Access published online on March 22, 2006
American Journal of Epidemiology, doi:10.1093/aje/kwj122
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1 Department of Pediatrics, University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
* To whom correspondence should be addressed. The purpose of this analysis was to examine the efficacy of prophylactic hematopoietic colony-stimulating factors (CSFs) in pediatric cancer and to describe how a Bayesian meta-analysis can be conducted and then modified to incorporate information not readily included in a frequentist meta-analysis. Three Bayesian models were developed. The simplest model used the same data as a published frequentist meta-analysis. The second model included data that could not easily be incorporated into the frequentist meta-analysis, including data from different courses of chemotherapy and continuous outcomes that did not report variance estimates. The third model examined the effect of CSF type (granulocyte CSF vs. granulocyte-macrophage CSF). Compared with the frequentist model, the Bayesian model with the most data suggested a greater benefit of CSFs, with a 3.2-day reduction in duration of parenteral antibiotics (95% credible interval: -7.1, 0.7) in the expanded Bayesian model compared with a 0.8-day (95% confidence interval: -2.3, 0.7) reduction in the frequentist model. Bayesian meta-analysis also suggested that, compared with granulocyte-macrophage CSF, granulocyte CSF was associated with a 4.8-day decrease in the duration of parenteral antibiotics. Bayesian meta-analysis can readily include information not easily incorporated in a frequentist meta-analysis. Some treatment effect estimates were larger by a clinically important amount when additional data contributed to the pooled estimate.
Received May 16, 2005
Accepted November 29, 2005
META-ANALYSIS
A Bayesian Meta-analysis of Prophylactic Granulocyte Colony-Stimulating Factor and Granulocyte-Macrophage Colony-Stimulating Factor in Children with Cancer
L. Sung 1 *,
J. Beyene 2,
J. Hayden 3,
P. C. Nathan 4,
B. Lange 5,
and
G. A. Tomlinson 2
2 Department of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada
3 The Institute for Work and Health, Toronto, Ontario, Canada
4 Department of Pediatrics, University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada
5 Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA
L. Sung, E-mail: Lillian.sung{at}sickkids.ca
Abstract 
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