Abstract
 The objective of this study was to describe the general approaches of doseresponse metaanalysis (DRMA) available for the quantitative synthesis of data using the R software. We conducted a DRMA using two types of data, the difference of means in continuous data and the odds ratio in binary data. The package commands of the R software were “doseresmeta” for the overall effect sizes that were separated into a linear model, quadratic model, and restricted cubic split model for better understanding. The effect sizes according to the dose and a test for linearity were demonstrated and interpreted by analyzing onestage and twostage DRMA. The authors examined several flexible models of exposure to pool studyspecific trends and made a graphical presentation of the doseresponse trend. This study focused on practical methods of DRMA rather than theoretical concepts for researchers who did not major in statistics. The authors hope that this study will help many researchers use the R software to perform DRMAs more easily, and that related research will be pursued.

Keywords: Metaanalysis, Dose response, Quadratic model, Restricted cubic spline, Nonlinearity, Dosresmeta
INTRODUCTION
 The basic purpose of doseresponse metaanalysis (DRMA) is to reveal the relationship between disease risk and exposure dose [13].
 If there are multiple effect sizes according to the doses of medicine when statistics are extracted in studies for metaanalysis, the researcher may be puzzled about whether to analyze only one effect size or the effect sizes of all doses in one study. If he or she chooses the former, this may result in selection bias even before the research is begun; if the latter is chosen, there is no adequate metaanalysis method.
 The most appropriate statistical method in this case is DRMA. It is particularly useful because it can show the trend of risks according to the exposure dose when the risks of exposure doses are presented as three or more categorical data [3].
 Recently, various tools for DRMA were developed. In particular, the “dosresmeta” package of R software and the “drmeta” of STATA software using the twostage method developed by Nicola Orsini can analyze even continuous data that could not be dealt with in the past [4].
 In this study, previous metaanalysis studies performed by the authors [13] are reviewed using the R software. Furthermore, this study requires prior knowledge about DRMA because it focuses on using the basic commands of R and plotting methods required for performing DRMA.
UNDERSTANDING DOSERESPONSE METAANALYSIS
 Doseresponse metaanalysis model
 Greenland & Longnecker [5] proposed a method of estimating linear trends using generalized leastsquare regression to correlate between the referent group and risk at each exposure dose level. Furthermore, Berlin et al. [6] proposed a twostage metaanalysis method that applied a random effect regression model to multiple doseresponse studies.
 A twostage metaanalysis consists of obtaining the regression coefficient of each individual study in the first stage, and calculating the total coefficient by converging the weighted averages of the regression coefficients of individual studies in the second stage. However, this method is not applicable to nonlinear relationships, although it can be applied when a linear trend is assumed [3].
 Therefore, an analysis method that assumes nonlinearity is required, and an analysis method that assumes a nonlinear trend when examining the effect size for each dose level was developed [7]. Liu et al. [8] suggested a method of applying a quadratic random effect model that converges well even in a nonlinear relationship, and Orsini & Greenland [9] discretized a flexible nonlinear model with restricted cubic splines (RCS). Consequently, the current standardized DRMA method statistically tests for nonlinearity and shows it graphically [13].
 Among the models that are dependent on time and dose, nonlinear models such as the quadratic model and RCS model generally tend to reflect phenomena better than linear models [2]. Therefore, when performing a first analysis, efforts should be made to find the most appropriate model for the research after sufficiently reviewing various models.
 Determining the exposure dose
 There are few doseresponse studies that accurately present specific doses. Most of them present doses as medians or ranges. Doses presented as medians can be used as they are, but the ranges must be converted to specific doses.
 The basic method is as follows:
 First, the dose of the reference group is zero (e.g., when the odds ratio [OR] is 1). Second, if the beginning of the smallest dose group is open, then the median of the corresponding group is set as the dose assuming that the beginning is zero (e.g., 5 if <10). Third, if the beginning and end of a dose group are closed by specific values, then the median is set as the dose (e.g., 15 if 1020). Fourth, if the end of the largest dose group is open, the value of the median of the previous dose group minus the beginning value of the previous dose group (e.g., 1510=5) is added to the beginning value of the last group, and the resulting value is set as the dose (e.g., 25 if >20) [13].
DOSERESPONSE METAANALYSIS USING “DOSRESMETA” PACKAGE OF R

Figure 1 shows the flow of a DRMA. When coding the first data item, the variable names must be changed appropriately for the corresponding function. An analysis that assumes linearity and an analysis that assumes nonlinearity are performed simultaneously, and then the result is reported.
 The “dosresmeta” package is needed to perform DRMA in R. Furthermore, the “mvtnorm,” “ellipse,” and “mvmeta” packages related to multivariate metaanalysis and the “rms” package for a RCS must also be installed in advance, as follows:
 · install.packages(“dosresmeta”)
 · install.packages(“mvtnorm”)
 · install.packages(“ellipse”)
 · install.packages(“mvmeta”)
 · install.packages(“rms”)
 In addition, you should install the “meta,” “metafor,” and “rmeta” packages for general intervention metaanalysis in R, as follows:
 · install.packages(“meta”)
 · install.packages(“metafor”)
 · install.packaqes(“rmeta”)
 For detailed explanations about DRMA, you can refer to the detailed codes, documents, and references for each package [4].
 We mark R commands with a dot (‘· ’) in front of them, to distinguish them from the main text. When long commands are extended to the next line, there is no dot at the beginning of the next line. Thus, when you enter the command in the R software, you must type them without the dot (‘· ’) in front of them.
 Binary data example
Data coding and loading
 As example binary data for DRMA, the risk of cardiovascular disease (CVD) according to alcohol intake was extracted from the example data of R (Supplementary Material 1).
 One thing to note when coding data is to distinguish studies by id numbers. In addition, for type, you must enter cc, ir, or ci for case control, incidence rate, or cumulative incidence, respectively.
 Load the example file to the memory of R from the working folder by using the following command. One thing to note is that R prefers the commaseparated value (csv) file format. Thus, you should save the data in Supplementary Material 1 as “drma_bin.csv” in the specified working folder.
 ·data_bin < read.csv(“drma_bin.csv”, header=TRUE)
 “read.csv” is a function for loading a csv file. The above command means to load the file “drma_bin.csv” and use the first variable name of the file (header=TRUE). This loaded file is saved as “data_bin” in the R memory.
 Scatter plot graph for raw data
 Before starting the model analysis, we will draw a scatter plot to see the overall outline of the example file.
 This is easier to understand intuitively if we use the inverse number of the standard error (SE) as a weight in the example binary data. Hence, the reverse SE variable is additionally created in the data_bin data.
 ·data_bin$inver_se < 1/data_bin$se
 For the graph, the “ggplot2” package is generally used.
 · library(ggplot2)
 · ggplot(data_bin, aes(dose, logrr, size=inver_se)) + geom_point(shape=1, colour=“black”) + scale_size_area(max_size=20)
 After loading the “ggplot2” package in the memory, sequentially enter the above arguments. There are three groups in total. The first ggplot part is the background of the graph, and geom_point and scale_size_area are options for appropriately expressing individual graphs.
 Enter the data name in the first parentheses for ggplot, and enter the horizontal axis variable (dose), vertical axis variable (logrr), and point variable (inver_se) in the “aes” function. The following parts set the size, color, and so on of the corresponding points. You can easily understand the individual elements by performing simulations several times.

Figure 2 shows a scatter plot for the dose and effect size (logrr). You can see the effect size for an individual dose. The size of the circle is the inverse number of the SE. Thus, a larger circle indicates a more accurate and better study.
 All of the effect sizes have an increasing trend except for the two effect sizes at the bottom right. Thus, we will test them using various analysis models.
Linear model
 To perform a DRMA, load the “dosresmeta” package:
 · library(dosresmeta)
 An analysis that assumes linearity is performed by treating the dose variables as a bundle.
 Each of the collected studies has one reference group. The command for calculating the total regression coefficient after converging the weighted averages of the regression coefficients of individual studies using the twostage method is as follows:
 · lin_bin < dosresmeta(formula=logrr ~ dose, id=id, type=type, se=se, cases=cases, n=n, data=data_bin)
 · summary(lin_bin)
 The linear model lin_bin is created by entering various arguments in the “dosresmeta” function. “formula” functions as a type of regression analysis in the DRMA. Hence, enter the dependent variable logrr after the formula, and the independent variable dose after “~”. Next, enter id, type, se, cases, and n. Then, set the data_bin with these variables.
 To examine the results of the summary command in the console window, this analysis is based on a twostage method developed by Nicola Orsini, the restricted maximum likelihood (REML) model, and uses the method of Greenland & Longnecker [5] for covariance.
 The estimated regression coefficient is 0.0044, which is statistically insignificant (p=0.4585).
 Furthermore, the pvalue (0.0147) and I^{2} value (64.7%) of the Cochrane Q statistics are shown, which indicate heterogeneity. Thus, it can be seen that this linear model has heterogeneity.
 The estimated regression coefficient is exponentialtransformed for interpretation because it was logtransformed.
 · predict(lin_bin, delta=1, exp=TRUE)
 After the exponential transformation, the risk is 0.996 (95% confidence interval [CI], 0.984 to 1.007). To interpret this, the risk of CVD increases by 0.996 times when one unit dose of alcohol is ingested (or decreases by 0.4%). However, this was statistically insignificant because the 95% CI includes 1.000.
 Linear model graph
 The linear model is plotted in Figure 3.
 · dosex_bin < data.frame(dose=seq(0, 80, 1))
 · with(predict(lin_bin, dosex_bin, order=TRUE, exp=TRUE), {plot(dose, pred, type=“l”, col=“blue”, ylim=c(0, 2), ylab=“cardiovascular disease relative risk”, xlab=“alcohol consumption, grams/day”)
 lines(dose, ci.lb, lty=2)
 lines(dose, ci.ub, lty=2)})
 The xaxis of the graph, dosex_bin, is set by making the dose from 0 to 80 as one unit with the “data.frame” function. This is also used as the xaxis in the following quadratic model and cubic spline model.
 The graphdrawing commands must be executed by using the entire “with” part at once.
 In the “with” part, you can directly specify the reference data for creating a graph. In the “predict” function, sequentially enter the linear analysis model (lin_bin), the xaxis of the graph (dosex_bin), and exponential transformation (exp=TRUE). In the final analysis, the “with” part means to draw a graph with the predicted values of the regression model obtained by entering the dose from 0 to 80 as one unit in the linear analysis model.
 Next, the “plot” function draws the actual graph corresponding to the dose on the xaxis and pred on the yaxis. The other commands are options to improve the look of the graph. You can learn their meanings by arbitrarily adding or removing them.
 ylim=c(0, 2) indicates the yaxis only between 0 and 2. You should adjust this value appropriately to express the graph properly. The last two lines are commands to add lines for a 95% CI.
 As with the interpretation of the regression coefficient of the linear model, the risk decreases with the dose. The blue solid line in the middle indicates the risk of CVD, and the upper and lower dotted lines indicate the 95% CI (Figure 3).
Quadratic model
 Now, we will create a quadratic model that does not assume perfect linearity. One simple method is to squaretransform the dose.
 The method of calculating the regression coefficient is the same as for the abovementioned linear model. When the model is established, the dose and dose square transformation are added to the independent variables.
 · quad_bin < dosresmeta(formula=logrr ~ dose + I(dose^2), id=id, type=type, se=se, cases=cases, n=n, data=data_bin)
 · summary(quad_bin)
 The “dosresmeta” function is used. Enter the dependent variable, logrr, after formula, and place the independent variables of dose and square of the dose after “~”. Then, enter id, type, se, cases, and n, and set the data_bin with these variables. This model is set as quad_bin.
 The total model is statistically significant with a pvalue of 0.0414.
 The regression coefficient of the estimated dose is 0.0302, which is statistically significant (p=0.022). Furthermore, the pvalue (0.0001) and I^{2} value (71.5%) of the Cochrane Q statistics are shown, which indicate heterogeneity. Thus, it can be seen that this model has heterogeneity.
 The estimated regression coefficient is exponentialtransformed for interpretation because it was logtransformed.
 · exp(0.0302)
 The risk after exponential transformation is 0.970. To interpret this, when 1 unit dose of alcohol is ingested, the risk of CVD increases by 0.970 times (or decreases by 3%). This is statistically significant.
 Quadratic model graph
 The quadratic model is plotted in Figure 4.
 · with(predict(quad_bin, dosex_bin, exp=TRUE), {plot(dose, pred, type=“l”, ylim=c(0, 15), ylab=“cardiovascular disease relative risk”, xlab=“alcohol consumption, grams/day”)
 lines(dose, ci.lb, lty=2)
 lines(dose, ci.ub, lty=2)})
 · points(dosex_bin$dose, predict(lin_bin, dosex_bin, exp=TRUE)$pred, type=“l”, lty=3, col=“blue”)
 The explanation of the graph command is the same as for the linear model.
 However, ylim=c(0, 15) means that the yaxis is displayed only between 0 and 15. These values must be adjusted appropriately to represent the graph properly.
 The last points command displays the linear model in the same graph.
 The black solid line in the middle indicates the risk, and the upper and lower black dotted lines indicate a 95% CI. The blue dotted line at the bottom indicates the risk of the linear model.
 The risk in the quadratic model is slightly different from the risk in the linear model. It is similar until a dose of approximately 40, but the risk tends to increase after that and increases sharply from 70. Therefore, according to the quadratic model, when the alcohol intake dose is high (higher than 40), the risk of CVD increases sharply (Figure 4).
Restricted cubic spline model
 We will create a cubic spline model among the nonlinear models. The method of calculating the regression coefficient is the same as in the abovementioned linear model, but the dose level must be subdivided beforehand.
 ■ Division of dose level
 The dose levels must be subdivided to examine the risk of a doseresponse at each level. What should be noted here is that the doses of individual studies are not the same, and the level setting of the dose group can be a problem because the relationship of the risk to the doseresponse is nonlinear. Therefore, the best approach to the dose group setting in a nonlinear relationship that has been developed until now is to subdivide the levels using RCS [13].
 · library(“rms”)
 · knots_bin < quantile(data_bin$dose, c(.05, .35, .65, .95))
 In R, RCS can be used through the “rms” package. After specifying data in the quantile function, the 5%, 35%, 65%, and 95% intervals are divided as vectors. The number and range of the dose levels can be adjusted appropriately. When you set four doses, a total of three dose levels are created for knots_bin (knots1).
 ■ Calculation of dose level risk (regression coefficient)
 · spl_bin < dosresmeta(formula=logrr ~ rcs(dose, knots_bin), type=type, id=id, se=se, cases=cases, n=n, data=data_bin)
 · summary(spl_bin)
 The “dosresmeta” function is used. Enter the dependent variable, logrr, in the formula. For independent variables, enter the dose and the previously divided three dose levels after “~” in the RCS function. Then, enter ID, type, se, cases, and n, and set the data_bin with these variables. This model is set as spl_bin.
 The goodness of fit of this model is statistically significant (p=0.038).
 The estimated regression coefficient for each dose level can be verified, but interpreting the risk for each dose level is meaningless because the dose levels were arbitrarily divided to test the linearity.
 ■ Testing the linearity of dose level risk (regression coefficient)
 The most important part in an analysis that assumes nonlinearity is to test whether the slopes of the regression lines for each dose level have statistically significant differences. If they do not show significant differences, it can be determined that there is linearity.
 In an analysis that assumes nonlinearity, the differences in the slopes of the three dose levels can be tested as follows:
 · waldtest(b=coef(spl_bin), Sigma=vcov(spl_bin), Terms=2:3)
 The command for testing linearity is “waldtest”. The first of the three dose levels is excluded because it is the total raw data itself, and the joint slope of the second and third dose levels is tested.
 The null hypothesis (H0): doses2=doses3=0.
 If the pvalue is larger than 0.05, the null hypothesis is accepted, and the joint slope is zero, meaning that there is no slope. Because the slopes of the two dose levels have no difference, it is determined that the model has linearity.
 If the pvalue is smaller than 0.05, the null hypothesis is rejected, and the joint slope is not zero. Thus, because there is a slope or the slopes of the two dose levels have a difference, it is determined that the model has nonlinearity.
 As a result of waldtest, the pvalue is 0.018. Therefore, this model has nonlinearity.
  Cubic spline model graph
 The cubic spline model is plotted in Figure 5.
 · xref_bin < 0
 · with(predict(spl_bin, dosex_bin, xref_bin, exp=TRUE),{plot(get(“rcs(dose, knots_bin)dose”), pred, type=“l”, ylim=c(0.4, 10), ylab=“cardiovascular disease relative risk”, xlab=“alcohol consumption, grams/day”, log=“y”, bty=“l”, las=1) matlines (get(“rcs(dose, knots_bin)dose”), cbind(ci.ub, ci.lb), col=1, lty=“dashed”)})
 · points(dosex_bin$dose, predict(lin_bin, dosex_bin, xref_bin, exp=TRUE)$pred, type=“l”, lty=3, col=“blue”)
 The explanation for the graph command is the same as in the linear model. xref_bin specifies a certain value for the dose reference variable. If you change the value of the reference variable appropriately according to the shape of the created graph, your discriminating ability will improve. Hence, you can set the value to zero at first and change it according to the shape of the graph.
 ylim=c(0.4, 10) means that the yaxis is displayed only between 0.4 and 10. The values must be adjusted appropriately to represent the graph properly. The last “points” command displays the linear model in the same graph.
 The black solid line in the middle indicates the risk, and the upper and lower black dotted lines indicate a 95% CI. The blue dotted line at the bottom indicates the risk of the linear model.
 The risk in the cubic spline model is slightly different from the risk in the linear model. It is similar until a dose of approximately 25, but the risk tends to increase after that and increases sharply from 40. Therefore, according to the cubic spline model, when the alcohol intake dose is high (higher than 30), the risk of CVD increases sharply (Figure 5).
  Adjusting the cubic spline model graph
 In Figure 5, the width of the 95% CI begins to decrease at a dose of approximately 17 and is recognized as an inflexion point. This value can be checked as follows:
 · pre_bin < predict(spl_bin, dosex_bin, exp=TRUE)
 · pre_bin$ci.ub  pre_bin$ci.lb
 When you calculate the width of the CI after obtaining all of the predicted values of the RCS model, you can see that the width is the smallest at the 17th dose, which is 0.2679, in the console window. Thus, the graph can be drawn again by setting this as the inflection point, as follows:
 · xref_bin < 17
 When the command for creating the cubic spline model graph is performed after changing the dose reference variable to 17, the graph in Figure 6 is obtained.
 After changing the value of the reference variable, Figure 6 shows a J shape, which rises at the left and right around the dose of 17. Therefore, more intuitive interpretation is possible.
 Continuous data example
 A continuous data example for the DRMA was extracted from the example data of R for the positive and negative syndrome scale, which measures the degree of schizophrenia according to the medicine dose (Supplementary Material 1). The commands for metaanalysis are almost identical to those in the binary data example. Refer to the reference [2] and appedix commands for detailed descriptions for continuous data.
CONCLUSION
 This study minimized statistical theory and focused on the actual performance of metaanalysis so that general researchers who have not majored in statistics can easily understand it. In other words, this study aimed to allow general researchers to adequately use already developed statistical methods in their field of study and to interpret the results.
 The R packages for DRMA can handle very powerful functions. Researchers can use these analysis methods once they familiarize themselves with the software. Furthermore, although it is not explained in this study, the “drmeta” command in STATA can be used. This is the same analysis tool.
 Furthermore, we hope that this study will help researchers perform metaanalyses more easily and pursue related research.
SUPPLEMENTARY MATERIALS
NOTES

^{} The authors have no conflicts of interest to declare for this study.
ACKNOWLEDGEMENTS
None.
Figure 1.Flowchart of doseresponse metaanalysis using the R “dosresmeta” package.
Figure 2.Scatter plot of binary sample data.
Figure 3.Linear model of binary sample data.
Figure 4.Quadratic model of binary sample data.
Figure 5.Restricted cubic spline model of binary sample data (reference = 0).
Figure 6.Restricted cubic spline model of binary sample data (reference = 17).
REFERENCES
 1. Hwang SD, Shim SR. Metaanalysis: from forest plot to network metaanalysis. Seoul: Hannarae; 2018. p 247266 (Korean).
 2. Shim SR. Dose response metaanalysis using R software. Gwacheon: SDB Lab; 2019. (Korean).
 3. Shim SR, Shin IS, Yoon BH, Bae JM. Doseresponse metaanalysis using STATA software. J Health Info Stat 2016;41:351358 (Korean).ArticlePDF
 4. Crippa A. The dosresmeta R package: performing multivariate doseresponse metaanalysis. [cited 2019 May 8]. Available from: https://alecri.github.io/software/dosresmeta.html.
 5. Greenland S, Longnecker MP. Methods for trend estimation from summarized doseresponse data, with applications to metaanalysis. Am J Epidemiol 1992;135:13011309.ArticlePubMedPDF
 6. Berlin JA, Longnecker MP, Greenland S. Metaanalysis of epidemiologic doseresponse data. Epidemiology 1993;4:218228.ArticlePubMed
 7. Greenland S. Avoiding power loss associated with categorization and ordinal scores in doseresponse and trend analysis. Epidemiology 1995;6:450454.ArticlePubMed
 8. Liu Q, Cook NR, Bergström A, Hsieh CC. A twostage hierarchical regression model for metaanalysis of epidemiologic nonlinear doseresponse data. Comput Stat Data Anal 2009;53:41574167.Article
 9. Orsini N, Greenland S. A procedure to tabulate and plot results after flexible modeling of a quantitative covariate. Stat J 2011;11:129.Article
Citations
Citations to this article as recorded by
 Associations of obesity indices change with cardiovascular outcomes: a doseresponse metaanalysis
Lyu Wang, Hanyue Ding, Yunyang Deng, Junjie Huang, Xiangqian Lao, Martin C. S. Wong
International Journal of Obesity.2024; 48(5): 635. CrossRef  The Best Exercise Modality and Dose for Reducing Pain in Adults With Low Back Pain: A Systematic Review With ModelBased Bayesian Network Metaanalysis
Zhide Liang, Shudong Tian, Chuanzhi Wang, Meng Zhang, Hengzhi Guo, Yingdanni Yu, Xianliang Wang
Journal of Orthopaedic & Sports Physical Therapy.2024; 54(5): 315. CrossRef  The influence of n3 polyunsaturated fatty acids on cognitive function in individuals without dementia: a systematic review and dose–response metaanalysis
Seung Wan Suh, Eunji Lim, SuhYuhn Burm, Hyungji Lee, Jong Bin Bae, Ji Won Han, Ki Woong Kim
BMC Medicine.2024;[Epub] CrossRef  Association of birth weight with cancer risk: a dose–response metaanalysis and Mendelian randomization study
Chao Chen, Xiaoying Chen, Donghong Wu, Huiting Wang, Chuqiao Wang, Jieni Shen, Yiran An, Ran Zhong, Caichen Li, Wenhua Liang
Journal of Cancer Research and Clinical Oncology.2023; 149(7): 3925. CrossRef  Protocol for a systematic review and metaanalysis on preoperative risk factors for failure after fixed sling implantation for postprostatectomy stress urinary incontinence
Emilio Sacco, Filippo Marino, Filippo Gavi, Stefano Moretto, Carlo Gandi, Riccardo Bientinesi, Francesco Pierconti, Pierfrancesco Bassi
F1000Research.2023; 12: 19. CrossRef  Does paternal age affect the live birth rate in donor oocyte cycles? A systematic review and metaanalysis
Emmanuelle Begon, Tiphaine Lefebvre, Elisangela Arbo, Sarah Bouée, Bernadette Darné, Frédérique Jaffré, Solène Languille, Dikra Mellouhi, JeanChristophe Pont, Noémie Rousset, Thomas Fréour
Journal of Assisted Reproduction and Genetics.2023; 40(3): 617. CrossRef  The Association between Prenatal Per and Polyfluoroalkyl Substances Exposure and Neurobehavioral Problems in Offspring: A MetaAnalysis
Huojie Yao, Yingyin Fu, Xueqiong Weng, Zurui Zeng, Yuxuan Tan, Xiaomei Wu, Huixian Zeng, Zhiyu Yang, Yexin Li, Huanzhu Liang, Yingying Wu, Lin Wen, Chunxia Jing
International Journal of Environmental Research and Public Health.2023; 20(3): 1668. CrossRef  Seizure risk in multiple sclerosis patients treated with diseasemodifying therapy: A systematic review and network metaanalysis
Yew Li Dang, Vivien TY Yong, Sifat Sharmin, Piero Perucca, Tomas Kalincik
Multiple Sclerosis Journal.2023; 29(6): 657. CrossRef  Hyponatremia and mortality in patients undergoing maintenance hemodialysis: Systematic review and meta‐analysis
Takamasa Miyauchi, Hiroki Nishiwaki, Aya Mizukami, Masahiko Yazawa
Seminars in Dialysis.2023; 36(4): 303. CrossRef  Effect of olive oil phenols on oxidative stress biomarkers: A systematic review and dose–response meta‐analysis of randomized clinical trials
Seyedeh‐Masomeh Derakhshandeh‐Rishehri, Asma Kazemi, Sung Ryul Shim, Mostafa Lotfi, Shabnam Mohabati, Mehran Nouri, Shiva Faghih
Food Science & Nutrition.2023; 11(5): 2393. CrossRef  Dose–Response MetaAnalysis of Corticosteroid Effects in SARS Outbreak: A Model for Risk Stratification and Screening Strategy for Osteonecrosis of Femoral Head PostCorticosteroid Therapy for COVID19
Sathish Muthu, Madhan Jeyaraman, Preethi Selvaraj, Naveen Jeyaraman, Anish Potty, Ashim Gupta
Life.2023; 13(4): 907. CrossRef  Vitamin D status and cognitive performance in communitydwelling adults: A doseresponse metaanalysis of observational studies
Janis D. Harse, Ross J. Marriott, Kun Zhu, Kevin Murray, Romola S. Bucks
Frontiers in Neuroendocrinology.2023; 70: 101080. CrossRef  Association between adiposity after diagnosis of prostate cancer and mortality: systematic review and metaanalysis
Margarita Cariolou, Georgios Markozannes, Nerea BecerraTomás, Rita Vieira, Katia Balducci, Dagfinn Aune, David C Muller, Doris S M Chan, Konstantinos K Tsilidis
BMJ Medicine.2023; 2(1): e000339. CrossRef  Using serum antiMüllerian hormone levels to predict the chance of live birth after spontaneous or assisted conception: a systematic review and metaanalysis
Maeliss Peigné, Valérie Bernard, Laura Dijols, Hélène Creux, Geoffroy Robin, Claude Hocké, Michaël Grynberg, Didier Dewailly, Charlotte Sonigo
Human Reproduction.2023; 38(9): 1789. CrossRef  The Weightloss Effect of GLP1RAs GlucagonLike Peptide1 Receptor Agonists in Nondiabetic Individuals with Overweight or Obesity: A Systematic Review with MetaAnalysis and Trial Sequential Analysis of Randomized Controlled Trials
Yupeng Liu, Binye Ruan, Huinan Jiang, Siyu Le, Yi Liu, Xuemei Ao, Yufeng Huang, Xudong Shi, Ru Xue, Xiaoyi Fu, Shuran Wang
The American Journal of Clinical Nutrition.2023; 118(3): 614. CrossRef  Type A aortic dissection: optimal annual case volume for surgery
Michal J Kawczynski, Sander M J van Kuijk, Jules R Olsthoorn, Jos G Maessen, Suzanne Kats, Elham Bidar, Samuel Heuts
European Heart Journal.2023; 44(41): 4357. CrossRef  Adherence to DataDriven Dietary Patterns and Lung Cancer Risk: A Systematic Review and Dose–Response MetaAnalysis
Roberto Fabiani, Gianandrea La Porta, Laura Li Cavoli, Patrizia Rosignoli, Manuela Chiavarini
Nutrients.2023; 15(20): 4406. CrossRef  Protocol for a systematic review and metaanalysis on preoperative risk factors for failure after fixed sling implantation for postprostatectomy stress urinary incontinence
Emilio Sacco, Filippo Marino, Filippo Gavi, Stefano Moretto, Carlo Gandi, Riccardo Bientinesi, Francesco Pierconti, Pierfrancesco Bassi
F1000Research.2023; 12: 19. CrossRef  Physical activity and cancer risk: a dose‐response analysis for the Global Burden of Disease Study 2019
Xiayao Diao, Yudong Ling, Yi Zeng, Yueqian Wu, Chao Guo, Yukai Jin, Xiaojiang Chen, Shoucheng Feng, Jianrong Guo, Chao Ding, Feiyu Diao, Zhicheng Du, Shanqing Li, Haibo Qiu
Cancer Communications.2023; 43(11): 1229. CrossRef  Electrical energy by electrode placement for cardioversion of atrial fibrillation: a systematic review and metaanalysis
Nicklas Vinter, Mikkel Zacharias Bystrup HolstHansen, Søren Paaske Johnsen, Gregory Y H Lip, Lars Frost, Ludovic Trinquart
Open Heart.2023; 10(2): e002456. CrossRef  Cancer risk based on alcohol consumption levels: a comprehensive systematic review and metaanalysis
Seunghee Jun, Hyunjin Park, UiJeong Kim, Eun Jeong Choi, Hye Ah Lee, Bomi Park, Soon Young Lee, Sun Ha Jee, Hyesook Park
Epidemiology and Health.2023; 45: e2023092. CrossRef  Increasing awareness of HIV pre‐exposure prophylaxis (PrEP) and willingness to use HIV PrEP among men who have sex with men: a systematic review and meta‐analysis of global data
Zhishan Sun, Qianfei Gu, Yifan Dai, Huachun Zou, Bruce Agins, Qiaosen Chen, Peiyang Li, Junchun Shen, Yi Yang, Hongbo Jiang
Journal of the International AIDS Society.2022;[Epub] CrossRef  Effects of thyroid dysfunction and thyroid stimulating hormone levels on the Atrial fibrillation risks: a systematic review and doseresponse metaanalysis from cohort studies
Min Huang, Shengyi Yang, Ge Ge, Hong Zhi, Lina Wang
Endocrine Practice.2022;[Epub] CrossRef  Paraben exposures and their interactions with ESR1/2 genetic polymorphisms on hypertension
Shuang Zhou, Hao Lu, Xu Zhang, Xueting Shi, Shunli Jiang, Lin Wang, Qing Lu
Environmental Research.2022; 213: 113651. CrossRef  The changes of IgE levels in type 2 inflammatory diseases after treatment of dupilumab: a systematic review and metaanalysis
Boyang Zhou, Jialin Dong, Surong Liang, Shuai Shang, Linfeng Li
Expert Review of Clinical Pharmacology.2022; 15(10): 1233. CrossRef  Is altitude a determinant of the health benefits of nature exposure? A systematic review and metaanalysis
Eunsoo Kim, Sujin Park, Soojin Kim, Yeji Choi, Jae Hyoung Cho, Geonwoo Kim
Frontiers in Public Health.2022;[Epub] CrossRef  Vitamin E Intake and Risk of Prostate Cancer: A MetaAnalysis
Wei Qi Loh, Jiyoung Youn, Wei Jie Seow
Nutrients.2022; 15(1): 14. CrossRef  Investigation of the Utility of Multivariate MetaAnalysis Methods in Estimating the Summary Dose Response Curve
Melepurakkal Sadanandan Deepthy, Kalesh Mappilakudy Karun, Kotten Thazhath Harichandrakumar, Narayanapillai Sreekumaran Nair
Journal of Research in Health Sciences.2022; 22(4): e00561. CrossRef  Prediction of the LongTerm Effect of Iron on Methane Yield in an Anaerobic Membrane Bioreactor Using Bayesian Network MetaAnalysis
Dawei Yu, Yushuai Liang, Rathmalgodagei Thejani Nilusha, Tharindu Ritigala, Yuansong Wei
Membranes.2021; 11(2): 100. CrossRef  The association between urate‐lowering therapies and treatment‐related adverse events, liver damage, and major adverse cardiovascular events (MACE): A network meta‐analysis of randomized trials
Siliang Zhang, Qiming Xie, Shuqing Xie, Jianwei Chen, Qingyue Deng, Ling Zhong, Jing Guo, Yuan Yu
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy.2021; 41(9): 781. CrossRef  Cancer Risk After Radioactive Iodine Treatment for Hyperthyroidism
Sung Ryul Shim, Cari M. Kitahara, Eun Shil Cha, SeongJang Kim, Ye Jin Bang, Won Jin Lee
JAMA Network Open.2021; 4(9): e2125072. CrossRef  Association between exposure to artificial sources of ultraviolet radiation and ocular diseases: a systematic review protocol
Polani Chandrasekar Rubeshkumar, Manickam Ponnaiah, Durgadoss Anandhi, Denny John
JBI Evidence Synthesis.2020; 18(8): 1766. CrossRef  Nonlinear Relationship between Tacrolimus Blood Concentration and Acute Rejection After Kidney Transplantation: A Systematic Review and DoseResponse MetaAnalysis of Cohort Studies
Saifu Yin, Turun Song, Xingxing Li, Hanyue Xu, Xueling Zhang, Yamei Jiang, Tao Lin
Current Pharmaceutical Design.2019; 25(21): 2394. CrossRef