Chapter 14 – Dose-Response Meta-Analysis – Systematic Reviews in Health Research

Nicola Orsini, Susanna C. Larsson, Georgia Salanti

Abstract

Characterizing the change in the risk of a health-related outcome according to the levels of an exposure is increasingly popular in systematic reviews. We provide an introduction to the statistical methods currently used to perform linear and nonlinear dose–response analysis based on aggregated data from multiple studies. We explain how dose–response associations are estimated within a study and summarized across studies. A re-analysis of observational studies about coffee consumption and mortality is used to illustrate how to move beyond a linear dose–response trend, and the complexity of making inference on risk ratios when using restricted cubic splines.

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Resources

See practicals below.

Practicals

R script and Stata do file for the analysis presented in Chapter 14

Chapter 14 R Script Download

Chapter-14-Stata-Script Download

Author affiliations

Nicola Orsini

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden

Susanna C. Larsson

Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

Georgia Salanti

Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland

How to cite this chapter?

For the printed version of the book

Orsini, N., Larsson, S.C. and Salanti, G. (2022). Chapter 14. Dose–response meta-analysis. In: Systematic Reviews in Health Research: Meta-analysis in Context (eds M. Egger, J.P.T. Higgins and G. Davey Smith), pp 258-269. Hoboken, NJ : Wiley.