Bayesian random-effects meta-analysis with empirical heterogeneity priors for application in health technology assessment with very few studies

Abstract

In Bayesian random-effects meta-analysis, the use of weakly informative prior distributions is of particular benefit in cases where only a few studies are included, a situation often encountered in health technology assessment (HTA). Suggestions for empirical prior distributions are available in the literature but it is unknown whether these are adequate in the context of HTA. Therefore, a database of all relevant meta-analyses conducted by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) was constructed to derive empirical prior distributions for the heterogeneity parameter suitable for HTA. Previously, an extension to the normal-normal hierarchical model had been suggested for this purpose. For different effect measures, this extended model was applied on the database to conservatively derive a prior distribution for the heterogeneity parameter. Comparison of a Bayesian approach using the derived priors with IQWiG's current standard approach for evidence synthesis shows favorable properties. Therefore, these prior distributions are recommended for future meta-analyses in HTA settings and could be embedded into the IQWiG evidence synthesis approach in the case of very few studies.