On the Multilevel Nature of Meta-Analysis: A Tutorial, Comparison of Software Programs, and Discussion of Analytic Choices.

The term "multilevel meta-analysis" is encountered not only in applied research studies, but in multilevel resources comparing traditional meta-analysis to multilevel meta-analysis. In this tutorial, we argue that the term "multilevel meta-analysis" is redundant since all meta-analysis can be formulated as a special kind of multilevel model. To clarify the multilevel nature of meta-analysis the four standard meta-analytic models are presented using multilevel equations and fit to an example data set using four software programs: two specific to meta-analysis (metafor in R and SPSS macros) and two specific to multilevel modeling (PROC MIXED in SAS and HLM). The same parameter estimates are obtained across programs underscoring that all meta-analyses are multilevel in nature. Despite the equivalent results, not all software programs are alike and differences are noted in the output provided and estimators available. This tutorial also recasts distinctions made in the literature between traditional and multilevel meta-analysis as differences between meta-analytic choices, not between meta-analytic models, and provides guidance to inform choices in estimators, significance tests, moderator analyses, and modeling sequence. The extent to which the software programs allow flexibility with respect to these decisions is noted, with metafor emerging as the most favorable program reviewed.

Neuropsychological Test Administration by Videoconference: A Systematic Review and Meta-Analysis.

The purpose of the current systematic review and meta-analysis was to assess the effect of videoconference administration on adult neurocognitive tests. We investigated whether the scores acquired during a videoconference administration were different from those acquired during on-site administration. Relevant counterbalanced crossover studies were identified according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twelve studies met criteria for analysis. Included samples consisted of healthy adults as well as those with psychiatric or neurocognitive disorders, with mean ages ranging from 34 to 88 years. Heterogenous data precluded the interpretation of a summary effect for videoconference administration. Studies including particpants with a mean age of 65-75, as well as studies that utilized a high speed network connection, indicated consistent performance across videoconference and on-site conditions, however studies with older participants and slower connections were more variable. Subgroup analyses indicated that videoconference scores for untimed tasks and those allowing for repetition fell 1/10th of a standard deviation below on-site scores. Test specific analyses indicated that verbally-mediated tasks including digit span, verbal fluency, and list learning were not affected by videoconference administration. Scores for the Boston Naming Test fell 1/10th of a standard deviation below on-site scores. Heterogenous data precluded meaningful interpretation of tasks with a motor component. The administration of verbally-mediated tasks by qualified professionals using existing norms was supported, and the use of visually-dependent tasks may also be considered. Variability in previous studies indicates a need for further investigation of motor-dependent tasks. We recommend the development of clinical best practices for conducting neuropsychological assessments via videoconference, and advocate for reimbursement structures that allow consumers to benefit from the increased access, convenience, and cost-savings that remote assessment provides.