Bridging Statistical Rigor and Clinical Usability: The CORMeta App for Meta-Analysis of Correlated Outcomes
Abstract
Background: In clinical research, multiple outcomes are often measured within the same cohort, leading to statistical dependencies that violate assumptions of traditional meta-analytic methods. While advanced models can accommodate such correlations, they typically require programming expertise, limiting accessibility for many physician-researchers.
Objective: We present a user-friendly, interactive Shiny web application designed to perform meta-analyses of correlated outcomes, with particular relevance for cohort-based clinical datasets.
Methods: The application implements a modified multivariate meta-analytic framework that accounts for the correlation structure of outcomes within cohorts. Users can upload their data, define correlation matrices, and filter observations by any variable (e.g., age, domain, exposure) without writing code. The application provides graphical output (forest plots) along with estimates of overall effect size, heterogeneity (τ²), and p-values.
Results: A demonstration dataset on prenatal alcohol exposure and neurodevelopmental outcomes is simulated to illustrate the application’s functionality. The application automatically generates correlation matrices where needed, adjusts for intra-cohort dependencies, and produces interpretable results suitable for clinical research reports.
Conclusion: This open-access application bridges the gap between complex statistical modeling and clinical usability. It enables physicians to conduct robust meta-analyses of correlated outcomes with ease, supporting evidence-based practice and local research initiatives. The tool is particularly valuable in multi-domain or multi-cohort studies where outcome correlation is non-negligible.
Keywords
meta-analysis, correlated outcomes, Shiny app, clinical research, multivariate models
Thanks
The author would like to express their sincere gratitude to Joseph L. Jacobson, and Sandra W. Jacobson for their valuable contributions to the conceptualization of this work. The idea for the CORMeta application originated from a project in which they served as Principal Investigators. Their insightful feedback on the functionality and usability of the tool greatly informed its development.
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