Dose-response Meta-analysis (DRMA) is a type of Meta-analysis based on multiple original studies that provide data on dose-response relationships and quantitatively combine their dose-response results to produce a comprehensive dose-response line or curve, which is widely used in evidence-based evidence generation and clinical decision-making. The reliability of published DRMA results and the quality of articles vary, and there is no uniform reporting standard for DRMA in the interna-tional arena. This study systematically review the nature of DRMA, statistical methods of each step and common statistical analysis problems, in order to improve the overall understanding of DRMA from a statistical perspective and lay a certain theoretical foundation for improving the overall quality of DRMA in China.

1.于云祥, 张超, 翁鸿, 等. 剂量-反应Meta分析之线性关系及分段线性回归模型的应用[J].中国循证医学杂志, 2016, 16(1): 111-114. [Yu YX, Zhang C, Weng H, et al. How to conduct dose-response meta-analysis by using linear relation and piecewise linear regression model[J]. Chinese Journal of Evidence-Based Medicine, 2016, 16(1): 111-114.] DOI: 10.7507/1672-2531.20160020.

2.徐畅, 张永刚, 韩芳芳, 等. 剂量-反应关系Meta分析的方法学简介[J].中国循证医学杂志, 2015, 15(10): 1236-1239. [Xu C, Zhang YG, Han FF, et al. How to perform dose-response meta-analysis: a brief intro-duction of methodology[J]. Chinese Journal of Evidence-Based Medicine, 2015, 15(10): 1236-1239.] DOI: 10.7507/1672-2531.20150204.

3.Orsini N, Li R, Wolk A, et al. Meta-analysis for linear and nonlinear dose-response relations: examples, an evaluation of approximations, and software[J]. Am J Epidemiol, 2012, 175(1): 66-73. DOI: 10.1093/aje/kwr265.

4.米子硕, 高锦, 李昊洋, 等. 临床实践指南与系统评价/Meta分析注册平台的比较与应用[J].医学新知, 2022, 32(2): 90-98. [Mi ZS, Gao J, Li HY, et al. Comparison and application of clinical practice guidlines and system review/Meta-analysis registration platforms[J]. New Medicine, 2022, 32(2): 90-98.] DOI: 10.12173/j.issn. 1004-5511.202201029.

5.方程, 邓巍, 樊景春, 等. 系统评价与Meta分析的注册平台简介[J].同济大学学报(医学版), 2019, 40(3): 380-387. [Fang C, Deng W, Fan JC, et al. Platforms for systematic review and meta-analysis registration:a briefly introduction[J]. Journal of Tongji University (Medical Science), 2019, 40(3): 380-387.] DOI: 10.16118/j.1008－0392.2019.03.022.

6.Xu C, Cheng LL, Liu Y, et al. Protocol registration or development may benefit the design, conduct and reporting of dose-response meta-analysis: empirical evidence from a literature survey[J]. BMC Med Res Methodol, 2019, 19(1): 78. DOI: 10.1186/s12874-019-0715-y.

7.Jiang Q, Liu Q, Chen F, et al. Reporting quality and statistical analysis of published dose-response me-ta-analyses was suboptimal: a cross-sectional literature survey[J]. J Clin Epidemiol, 2019, 115: 133-140. DOI: 10.1016/j.jclinepi.2019.07.008.

8.Aune D, Saugstad OD, Henriksen T, et al. Maternal body mass index and the risk of fetal death, stillbirth, and infant death: a systematic review and meta-analysis[J]. JAMA, 2014, 311(15): 1536-1546. DOI: 10.1001/jama.2014. 2269.

9.Liu TZ, Xu C, Rota M, et al., Sleep duration and risk of all-cause mortality: a flexible, non-linear, me-ta-regression of 40 prospective cohort studies[J]. Sleep Med Rev, 2017, 32: 28-36. DOI: 10.1016/j.smrv.2016.02.005.

10.Hamling J, Lee P, Weitkunat R, et al. Facilitating meta-analyses by deriving relative effect and precision estimates for alternative comparisons from a set of estimates presented by exposure level or disease category[J]. Stat Med, 2008, 27(7): 954-970. DOI: 10.1002/sim.3013.

11.周权, 郭鹏, 钟国超, 等. 有序多分类剂量反应资料Meta分析中原始研究参照组转换及软件实现[J].循证医学, 2016, 16(1): 60-64. [Zhou Q, Guo P, Zhong GC, et al. Transforming the reference group of discrete correlated data in original study of dose- response meta-analysis[J]. The Journal of Evidence-Based Medicine, 2016, 16(1): 60-64.] DOI: 10.12019/j.issn.1671-5144.2016.01.015.

12.徐畅, 刘同族, 邝心颖, 等. 剂量-反应Meta分析模型中缺失值的评估及效应指标的转换[J].中国循证医学杂志, 2015, 15(8): 984-987. [Xu C, Liu TZ, Kuang XY, et al. How to estimate the missing data and transform the eff ect measure in dose-response meta-analysis[J]. Chinese Journal of Evidence-Based Medicine, 2015, 15(8):  984-987.] DOI: 10.7507/1672-2531.20150164.

13.Altman DG, Bland JM. How to obtain the P value from a confidence interval[J]. BMJ, 2011, 343: d2304. DOI: 10.1136/bmj.d2304.

14.李立明,主编. 流行病学, 第6版 [M]. 北京: 人民卫生出版社, 2018.

15.Orsini N. From floated to conventional confidence intervals for the relative risks based on published dose-response data[J]. Comput Methods Programs Biomed, 2010, 98(1):  90-93. DOI: 10.1016/j.cmpb.2009.11.005.

16.Xu C, Kwong JS, Zhang C. The use of piecewise linear spline function on dose-response meta-analysis[J]. Ann Transl Med, 2016, 4(19): 389. DOI: 10.21037/atm.2016.09.28.

17.Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses[J]. BMJ, 2003, 327(7414): 557-560. DOI: 10.1136/bmj.327.7414.557.

18.DerSimonian R, Laird N. Meta-analysis in clinical trials[J]. Control Clin Trials, 1986, 7(3): 177-188. DOI: 10.1016/0197-2456(86)90046-2.

19.黄育北, 李卫芹, 席波, 等. 剂量反应关系Meta分析的模型选择及分析流程[J].中国循证医学杂志, 2016, 16(2): 223-228. [Huang YB, Li WQ, Xi B, et al. Model selection and statistical process of meta-analysis of dose-response data[J]. Chinese Journal of Evidence-Based Medicine, 2016, 16(2): 223-228.] DOI: 10.7507/1672-2531.20160035.

20.张超, 高峥岩, 黄静宇, 等. 剂量-反应Meta分析之两种不同随机效应模型的应用[J]. 中国循证医学杂志, 2017, 17(5): 616-620. [Zhang C, Gao ZY, Huang JY, et al. The application of two random- effect models for dose-response meta- analysis[J]. Chinese Journal of Evidence-Based Medicine, 2017, 17(5): 616-620.] DOI: 10.7507/1672-2531.201703042.

21.黄静宇, 张超, 李胜, 等. 剂量-反应Meta分析之限制性立方样条函数的应用[J].中国循证医学杂志, 2015, 15(12): 1471-1474. [Huang JY, Zhang C, Li S, et al. How to conduct a dose-response meta-analysis: the use of restricted cubic spline model[J]. Chinese Journal of Evidence-Based Medicine, 2015, 15(12): 1471-1474.] DOI: 10.7507/1672-2531.20150239.

22.Xu C, Zhang C, Kwong JS. Be care the risk of under fit in dose-response meta-analysis when using cubic spline[J]. Ann Transl Med, 2016, 4(19): 388. DOI: 10.21037/atm.2016.09.27.

23.罗美玲, 林希建, 刘如春, 等. 剂量反应关系Meta分析在Stata软件中的实现[J].循证医学, 2014, 14(3): 182-187. [Luo ML, Lin XJ, Liu RC, et al. Realizing the dose response meta-analysis in stata software[J]. The Journal of Evidence-Based Medicine, 2014, 14(3): 182-187.] DOI: 10.3969/j.issn.1671-5144.2014.03.012.

24.周权, 李卉, 罗美玲, 等. 剂量反应关系Meta分析在R软件中的实现[J].现代预防医学, 2015, 42(5): 789-794. [Zhou Q, Li H, Luo ML, et al. Implementation of dose- response for meta- -analysis in R software[J]. Modern Preventive Medicine, 2015, 42(5): 789-794.]  https://d.wanfangdata.com.cn/periodical/xdyfyx201505007.

25.周权, 罗美玲, 王冕, 等. 应用SAS软件宏命令实现剂量反应关系Meta分析[J].循证医学, 2015, 15(1): 54-59. [Zhou Q, Luo ML, Wang M, et al. Application of SAS software macro for realizing the dose response me-ta-analysis[J]. The Journal of Evidence-Based Medicine, 2015, 15(1): 54-59.] DOI: 10.3969/j.issn.1671-5144. 2015.01.015.

26.徐畅, 曾宪涛, 张超, 等. 应用R软件dosresmeta程序包和mvmeta程序包实现剂量-反应关系Meta分析[J].中国循证医学杂志, 2015, 15(4): 479-483. [Xu C, Zeng XT, Zhang C, et al. Performing meta-analysis of dose- re-sponse data using dosresmeta and mvmeta packages in R [J]. Chinese Journal of Evidence-Based Medi-cine, 2015. 15(4): 479-483.] DOI: 10.7507/1672-2531.20150079.

27.郭鹏, 徐畅, 周权, 等. 剂量-反应Meta分析之软件的应用[J].中国循证医学杂志, 2016, 16(3): 363-368. [Guo P, Xu C, Zhou Q, et al. How to conduct dose-response meta- analysis: the application of software[J]. Chinese Journal of Evidence-Based Medicine, 2016. 16(3):  363-368.] DOI: 10.7507/1672-2531.20160056.

28.曾宪涛, 主编. 应用STATA做Meta分析（第二版）[M]. 北京: 中国协和医科大学出版社, 2017.

29.张天嵩, 主编. 实用循证医学方法学（第三版）[M]. 北京: 中南大学出版社, 2021.

30.Xu C, Zhang C, Wang XL, et al. Self-fluid management in prevention of kidney stones: a PRIS-MA-compliant systematic review and dose-response meta-analysis of observational studies[J]. Medi-cine (Baltimore), 2015, 94(27): e1042. DOI: 10.1097/MD.0000000000001042.

31.徐畅, 张超, 邝心颖, 等. 剂量-反应Meta分析系列之非随机误差导致的偏倚的处理方法[J].中国循证医学杂志, 2016, 16(4): 488-491. [Xu C, Zhang C, Kuang XY, et al. How to conduct dose-response meta-analysis: method of adjustment of non-randomized error[J]. Chinese Journal of Evidence-Based Medicine, 2016, 16(4): 488-491.] DOI: 10.7507/1672-2531.20160075.

32.张维欣, 熊莺, 徐畅, 等. 中文期刊发表的剂量-反应Meta分析方法学质量及报告质量现状[J].中国循证心血管医学杂志, 2017, 9(11): 1300-1304. [Zhang WX, Xiong Y, Xu C, et al. Methodological and reporting quality of dose-response meta-analyses published in Chinese journals[J]. Chinese Journal of Evidence-Based Car-diovascular Medicine, 2017, 9(11): 1300-1304.] DOI: 10.3969/jissn.1674- 4055.2017.11.04.

33.Xu C, Liu Y, Jia PL, et al. The methodological quality of dose-response meta-analyses needed substantial improvement: a cross-sectional survey and proposed recommendations[J]. J Clin Epidemiol, 2019, 107: 1-11. DOI: 10.1016/j.jclinepi.2018.11.007.

34.Xu C, Liu TZ, Jia PL, et al. Improving the quality of reporting of systematic reviews of dose-response meta-analyses: a cross-sectional survey[J]. BMC Med Res Methodol, 2018, 18(1): 157. DOI: 10.1186/s12874-018-0623-6.

35.徐畅, SUHAIL A.R.DOI, 张超, 等. 剂量-反应Meta分析报告指南(中文版)[J]. 中国循证医学杂志, 2016, 16(10): 1221-1226. [Xu C, SUHAIL A.R.DOI, Zhang C, et al. Proposed Reporting Guideline for Dose-response Meta-analysis (Chinese Edition) [J]. Chinese Journal of Evidence-Based Medicine, 2016, 16(10): 1221-1226.] DOI: 10.7507/1672- 2531.20160185.