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Stat Med. 2002 Oct 15;21(19):2971-80.

Issues in the meta-analysis of cluster randomized trials.

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  • 1Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, N6A 5C1, Canada.


Meta-analyses involving the synthesis of evidence from cluster randomization trials are being increasingly reported. These analyses raise challenging methodologic issues beyond those raised by meta-analyses which include only individually randomized trials. In this paper we review and comment on a selected number of these issues, including problems of study heterogeneity, difficulties in estimating design effects from individual trials and the choice of statistical methods.

Copyright 2002 John Wiley & Sons, Ltd.

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