Prototype of an Interactive Meta Analysis

Case Study: The effectiveness of face masks in preventing the spread of COVID-19

This is a prototype and case study of an ‘interactive meta-analysis’. The main aim is to showcase how an interactive meta-study could look like and thereby explore its potential to be used as a tool to improve evidence-based decision making. More on the concept of an interactive meta-study here.


What is this for?

Like a normal Meta Study, this page aims to combine results from multiple studies on the same topic (in this case mask wearing to prevent the spread of COVID-19) to create one "overall" estimate. However, contrary to a traditional meta study you can choose what studies are included and what criteria they have to meet. Hover over the visualisation to get addtional explanations.

Based on the
8
studies included our current best estimate is that those who don't wear a mask are
2.46
times more likely to get COVID than those who wear masks.
If we assume that people without a mask have a
22
% chance of getting COVID (which is the median from all included studies), this means that (in expectation)
8
more people would need to wear mask to prevent one COVID case.
Continent of Study

Individual Studies

Bundgaard 20211.23 [ 0.82 - 1.85 ]Doung-Ngen 20204.35 [ 1.67 - 11.11 ]Lio 20213.26 [ 1.15 - 9.17 ]Xu 202011.03 [ 26.84 - 4.53 ]Wang 202027.34 [ 1.59 - 470.79 ]Chen 2021 2.86 [ 0.99 - 8.26 ]Guo 2020 5.34 [ 1.83 - 15.59 ]Khalil 20202.68 [ 1.49 - 4.82 ]Study ID Favors Mask Usage →Odds ratio [95% CI]1510204080160360FF2.46 [ 1.88 - 3.21 ]RF3.47 [ 1.96 - 6.14 ]Estimated Hypermean (Fixed Effects Model): 2.46Axis is in log scaleEstimated Hypermean (Random Effects Model): 3.47

Sample Size
721051904918291,1364,8625,120

More on Methods

The odds ratio in this case represents the odds that someone without a mask will get COVID divided by the odds that someone with a mask will get COVID: It is calculated as follows: OR=people who wore a mask & got COVIDpeople who wore a mask & didn't get COVIDpeople who did not wear a mask & got COIVDpeople who did not wear a mask & didn't get COVID

More information: Szumilas, M. (2010): Explaining Odds Ratios.

A so-called 'fixed effects model' is probably the simplest version of calculating meta-estimates. It uses the 'inverse-variance method' to calculate the weighted average of the included studies as: meta-estimate=YiWiWi
where Yi is the estimated effect size from the ith study, Wi is the weight assigend to study i and the summation is across all studies.
In the fixed effects model, Wi=1SEi2 with SEi being the standard error of study i.
This type of analysis assumes that all effect estimates are estimating the same underlying effect. More information: Borenstein, M.; Hedges, L.; Higgins, J.; Rothstein, H (2009): A basic introduction to fixed-effect and random-effects models for meta-analysis

Random effects models are a variation of the 'inverse-variance method' that is also used in fixed effects models. However, they operate on the assumption that the different studies included in the meta-analysis estimate different but related effects. The general formula for calculating the aggregated effect estimate is the same as in the fixed effects model: meta-estimate=YiWiWi
where Yi is the estimated effect size from the ith study, Wi is the weight assigend to study i and the summation is across all studies.
However, the weights of the studies take into account the between-study variance T2: Wi=1(T2+SEi2)
You can find information on how to calculate T2 in: Borenstein, M.; Hedges, L.; Higgins, J.; Rothstein, H (2009): A basic introduction to fixed-effect and random-effects models for meta-analysis

More on the Included Studies

We have included studies that we sourced from the following existing meta-studies:

Below you can find links to the included studies, information on where exactly we took the estimates from as well as some detailed information and personal comments.

Notes:

  • Numbers are taken from table 2, p. 6

Notes:

  • Mask wearing defined as ÔAlways wearing a maskÕ
  • Odds ratio is the reported adjusted odds ratio from table 1,p.2611 ÒWearing masks incorrectly, such as not covering both nose and mouth, was considered the same as not wearing a mask for analyses. Crude odds ratios of wearing mask and of each factor evaluated were estimated using logistic regression with random effects for location and for index patient nested within the same location to take into account clustering; therefore, the crude odds ratios are not equal to dividing of the odds in the case group by the odds in the control groupÓ Doung-Ngern, 2020

Notes:

  • Mask Wearing defined as ÔWearing a mask whenever outdoorsÕ
  • Numbers are taken from table 4, p. 6
  • There seems to be a small error in the reported numbers, as the reported numbers do not add up to the reported sample size (one observation is missing). We have chosen 713 as the overall number of people wearing masks and 6 as the number of reported cases.

Notes:

  • Based on an online survey
  • Mask wearing defined as wearing a mask outdoors
  • Numbers taken from p.14
  • Estimates differ from the one reported in the meta-study by Talic 2021 . I was not able to find information on how Talic derive their estimate from the original data.

Notes:

  • In this study no COVID cases were registered in the mask-wearing group. In accordance with standard meta-analysis practices , we those recorded 0.5 as the quantity of observed cases to avoid computational problems.

Notes:

Notes: