Biomedical Systematic Review & Meta-Analysis
Clinical evidence synthesis and forest plot pooling across 42 randomized trials following PRISMA 2020 guidelines.
Project Overview & Research Question
An interdisciplinary clinical research team sought assistance to perform a rigorous systematic review and quantitative meta-analysis examining the comparative therapeutic efficacy and adverse outcome rates of novel biologic therapeutics versus conventional immunosuppressive regimens in autoimmune chronic inflammation.
Methodological Challenges
- Substantial statistical heterogeneity across published clinical trial reporting standards.
- Multiplicity of outcome measures (continuous disease activity scores vs. dichotomous remission thresholds).
- Need to construct reproducible, multi-database search strings across PubMed, EMBASE, and the Cochrane Central Register.
Our Advisory Intervention
Stalynus Research's biostatistics team structured an end-to-end evidence synthesis protocol:
- Search Protocol: Designed MeSH-optimized Boolean search algorithms, deduplicated 3,420 initial citations, and drafted the PRISMA flow diagram.
- Quality Appraisal: Guided dual-reviewer screening and applied the Cochrane Risk of Bias tool (RoB 2).
- Statistical Synthesis: Calculated standardized mean differences (Hedges' g) and risk ratios with 95% confidence intervals using random-effects DerSimonian-Laird and restricted maximum likelihood (REML) estimators in R.
- Heterogeneity & Publication Bias: Conducted subgroup meta-regressions to isolate dosage effects and verified funnel plot symmetry via Egger's linear regression test.
Key Outcomes
The final manuscript was successfully submitted and accepted by a Q1 journal in clinical pharmacology. Reviewers specifically commended the precision of the forest plots, GRADE evidence certainty tables, and reproducible R scripts provided in the supplementary material.