Preparing for Meta Analysis

Hello Everybody,

I am a physician and a researcher, have been studying the meta-analysis subject for a while now, and we are in the process to perform a metanalysis in the cardiology field in these days. Here it is a basic summary: although there are a lot of publications trying to understand best predictors of immediate right heart failure (RHF) in patients undergoing implant of a ventricular assist device (VAD, a sort of artificial heart), it is unclear what are the most significant and independent predictors of such endpoint. On the other hand, identifying patients at risk to develop RHF is critical because 1) their in hospital mortality is up to 50%, and 2) RHF is prevented by the implant of a Biventricular VAD (just a different type of artificial heart). In the last years, several potential predictors have been identified, pertaining to different areas of diagnostic tests (all obtained before procedure of VAD implantation). These areas can be summarized as follows: Demographic/Clinical parameters (age, gender, need for hemofiltration, need for mechanical intubation, BEFORE VAD implant), Biochemical measures (such as creatinine level, BUN, hepatic transaminases, number of platelets and so on), Echocardiographic values (dimensions of the heart before VAD implant, performance, intra-cardiac pressures...) and measures obtained in the cath-lab (such as cardiac output, pulmonary or systemic arteries resistance, pressures of the right ventricle obtained before VAD implant etc... ). As you can see, several potentially significant predictors have been identified, but no one has been proved to be definitely the most important. We would like to perform a meta-analysis to identify most independent predictors. I have also prepared a FileMaker Pro Database to collect data extracted from papers, and we are completing a level I screening on more than 528 potentially useful publications. I was thinking to proceed stratifying predictors basing on different "areas" (demographic/clinical, biomarkers, imaging, and cath-lab values) and finally performing a meta-regression to confirm (or not) identified predictors. I would like to know opinions from others though, what do you think, and if you would like to take a look at the database I have made to point me in the right direction. Any constructive advice will be greatly appreciated, thank you in advance, Diego
have you tried to conduct the MA under the umbrella of The Cochrane Collaboration? they can help you with methodological advices.