Bayesian random effects meta-analysis of trials with binary outcomes: methods for the absolute risk difference and relative risk scales.

In a recent Statistics in Medicine paper, Warn, Thompson and Spiegelhalter (WTS) made a comparison between the Bayesian approach to the meta-analysis of binary outcomes and a popular Classical approach that uses summary (two-stage) techniques. They included approximate summary (two-stage) Bayesian techniques in their comparisons in an attempt undoubtedly to make the comparison less unfair. But, as this letter will argue, there are techniques from the Classical approach that are closer-those based directly on the likelihood-and they failed to make comparisons with these. Here the differences between Bayesian and Classical approaches in meta-analysis applications reside solely in how the likelihood functions are converted into either credibility intervals or confidence intervals. Both summarize, contrast and combine data using likelihood functions. Conflating what Bayes actually offers to meta-analysts-a means of converting likelihood functions to credibility intervals-with the use of likelihood functions themselves to summarize, contrast and combine studies is at best misleading.