Example of subgroup analysis in metaanalysis

An IPD meta-analysis of thoracic radiotherapy for small-cell lung cancer [52] showed an overall benefit of combined radiotherapy and chemotherapy over chemotherapy alone (p = 0.001), equivalent to a 14 per cent reduction in the mortality rate. In addition, there was a significant trend (p = 0.01) towards a larger relative effect of radiotherapy on the mortality of younger patients than older ones. The relative risk of death in the treated group ranged from 0.72 for patients younger than fifty-five years to 1.07 for patients older than seventy years, with a very clear pattern of a decreasing benefit of radiotherapy across the five increasing age categories that were investigated. Although the authors suggested that the smaller effect of treatment in older patients could be explained by toxicity, they were sensibly cautious in interpreting the result of this subgroup analysis.

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