Abstract:Subgroup analyses are central to the assessment of benefits and risks, where recommendations may depend on evidence that treatment effects differ across patient groups. Valid subgroup claims require evidence based on (within-trial) interaction estimates while accounting for the heterogeneity in those interaction effects. In the common case of only a few available studies, inference may benefit from the use of prior information on the expected amount of heterogeneity. Although between-study heterogeneity~($\tau$) has been studied empirically for overall treatment effects, no such calibration exists for treatment-by-subgroup interaction effects. We derive empirical (predictive) prior distributions for overall and interaction effect heterogeneity from over 3{,}000 interaction meta-analyses drawn from the \emph{Cochrane Database of Systematic Reviews (CDSR)}. The resulting effect-measure-specific priors indicate that interaction heterogeneity tends to be substantially smaller than treatment effect heterogeneity. We also show that lower precision of within-trial interaction estimates makes interaction heterogeneity harder to identify. Therefore, the use of empirical priors is particularly valuable in sparse interaction meta-analyses. A motivating example illustrates how priors tailored to interaction effects may substantially improve precision in a meta-analysis compared with standard heterogeneity priors.
From: Renato Panaro [view email]
[v1]
Mon, 22 Jun 2026 21:47:33 UTC (283 KB)
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