ImpossibleMA: Bounded Synthesis of Cochrane Meta-Analyses Declared Unpoolable

Authors

Abstract

Cochrane meta-analyses whose prediction intervals cross the null are conventionally deemed unpoolable, leaving guideline panels with narrative synthesis. Screening 6,229 MetaAudit meta-analyses (68,519 audit rows) for any CRITICAL flag, only prediction_gap fires CRITICAL, so the contribution is the envelope construction, not multi-module triage. The Possibility Envelope—(lower, upper, point|None, min_info, assumptions)—is computed by an adversarial engine enumerating inclusion-rule combinations and reporting REML+HKSJ extremes. 444 of 6,229 (7.13%) carried a CRITICAL flag, all converted to bounded adversarial envelopes, zero unclassified. REML matches metafor::rma below 1e-6 (our house ideal; τ≈1e-7 except the degenerate τ²=0 boundary); monotonicity and full-data containment property-tested across 23 inputs, 182 tests gating every commit. The envelope bounds defensible pooled effects under stated rules, and one named datum—a pre-registered protocol—collapses it to a point; since the bounded set is defined by the same prediction_gap criterion, "unpoolable" is definitional, not external. v1 covers adversarial, k=1, and missing-SE cases; figure-extraction, incommensurable outcomes, and per-MA runs are deferred.

References

Schmidli H, Gsteiger S, Roychoudhury S, O'Hagan A, Spiegelhalter D, Neuenschwander B. Robust meta-analytic-predictive priors in clinical trials with historical control information. Biometrics. 2014;70(4):1023-1032. doi:10.1111/biom.12242

Viechtbauer W. Conducting meta-analyses in R with the metafor package. J Stat Softw. 2010;36(3):1-48. doi:10.18637/jss.v036.i03

Published

2026-06-20

Issue

Section

Methods Note

How to Cite

ImpossibleMA: Bounded Synthesis of Cochrane Meta-Analyses Declared Unpoolable. (2026). Synthesis, 2(4). https://synthesis-medicine.org/index.php/journal/article/view/impossible-ma

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