6.

Figure 6. Trial sequential analysis of the cumulative meta‐analysis of the effect of bezafibrate versus no intervention on concentration of serum bilirubin concentration in patients with primary biliary cirrhosis. The diversity‐adjusted required information size (DARIS) of 126 patients is calculated based on a minimal relevant intervention effect (MIREDIF) of 0.20 mg/dl, a standard deviation of 0.40 mg/dl, a risk of type I error of 5%, a power of 80%, and a diversity of 0%. The cumulated Z‐curve (blue curve) does not cross the trial sequential monitoring boundary implying that there is no firm evidence for a potentially beneficial effect of 0.20 mg/dl decrease in serum bilirubin concentration when the cumulative meta‐analysis is adjusted for sparse data and multiple testing on accumulating data.