Subgroup identification using individual participant data from multiple trials on low back pain

Abstract: Model-based recursive partitioning (MOB) and its extension, metaMOB, are potent tools for identifying subgroups with differential treatment effects. In the metaMOB approach random effects are used to model heterogeneity of the treatment effects when pooling data from various trials. In situations where interventions offer only small overall benefits and require extensive, costly trials with a large participant enrollment, leveraging individual-participant data (IPD) from multiple trials can help identify individuals who are most likely to benefit from the intervention. We explore the application of MOB and metaMOB in the context of non specific low back pain treatment, using synthesized data based on a subset of the individual participant data meta-analysis by Patel et al. Our study underscores the need to explore heterogeneity in intercepts and treatment effects to identify subgroups with differential treatment effects in IPD meta-analyses.