The Meta-Analytic Protocol

Defining the Scope

Author

A. C. Del Re

1. The Research Question (PICO)

A meta-analysis must be precise. We use the PICO framework: * Population: Who are the participants? (e.g., Adults with MDD) * Intervention: What is the treatment? (e.g., CBT) * Comparator: What is the control? (e.g., Wait-list, TAU, Placebo) * Outcome: What is being measured? (e.g., Depression Symptomology)

Critique: “Garbage In, Garbage Out.” Response: Strict inclusion criteria act as the filter.

2. Inclusion/Exclusion Criteria

We must define the “Universe of Studies”.

Criteria Category Examples of Inclusion Examples of Exclusion
Participants Age > 18; Primary dx of Depression Bipolar; Psychosis; Substance Use
Intervention Manualized CBT; > 8 sessions Bibliotherapy; Unstructured care
Design RCT (Randomized Controlled Trial) Pre-Post only; Quasi-experimental
Outcome BDI; HAM-D; QIDS (Continuous scales) Dichotomous “Success/Fail” only
Language English, German, Spanish Untranslatable
Timeframe 1980 - Present Pre-1980 (Outdated methods)

3. Literature Search Strategy

Where do we find the studies? 1. Databases: PubMed, PsycINFO, Embase, Cochrane Central. 2. Grey Literature: Dissertations (ProQuest), Conference Abstracts. (Critical to avoid Publication Bias!) 3. Forward/Backward Chaining: Checking references of included studies.

The Importance of Grey Literature

Publication bias impacts validity. We must search for “Grey Literature”:

  • Dissertations/Theses: often contain null results (ProQuest).
  • Conference Abstracts: Early data not yet published.
  • Government/Technical Reports: Non-academic sources.
  • Personal Communication: Emailing authors for missing data.

4. The Coding Manual

Coding Reliability

If multiple coders are used, we must assess Inter-Rater Reliability (IRR).

  • Cohen’s Kappa (\(\kappa\)): For categorical variables (e.g., Diagnosis type).
  • Intraclass Correlation (ICC): For continuous variables (e.g., Effect sizes).
  • Standard: Double-code at least 20% of studies. \(\kappa > 0.80\) is excellent.

Once studies are retrieved, we “extract” the data. This requires a Coding Dictionary.

Descriptors (Moderators)

  • Study Level: Year, Country, Funding Source.
  • Sample Level: Mean Age, % Female, Ethnicity, Comorbidity.
  • Treatment Level: Duration (weeks), Format (Group/Individual), Provider (PhD/MD).
  • Quality: Risk of Bias (Randomization, Blinding, Attrition).

Effect Size Data

For every outcome, we need: 1. Sample Size: \(N_{tx}\), \(N_{ctrl}\). 2. Means: \(M_{tx}\), \(M_{ctrl}\). 3. SDs: \(S_{tx}\), \(S_{ctrl}\). 4. Test Statistics: \(t\), \(F\), \(\chi^2\), exact \(p\)-values.

Rule: Extract everything. If precise stats are missing, extract \(p\)-values or \(N\) to impute later using compute.es.



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