(Meta)analyze this: Systematic reviews might lose credibility


Nature.com: September 07, 2012

Doctors and regulatory agencies rely on meta-analyses when setting clinical guidelines and making decisions about drugs. However, as the number of these analyses increases, it’s clear that many of them lack robust evidence from randomized trials, which may lead to the adoption of treatment modalities of ambiguous value. Without a more disciplined approach requiring a reasonable minimum amount of data, meta-analyses could lose credibility.

A well-performed meta-analysis can revive treatment options once considered ineffective or reveal the drawbacks of practices previously considered the gold standard. For example, initial reports suggested that the use of erythropoiesis-stimulating agents in patients with cancer could perhaps reduce the number of patients in need of blood transfusion due to anemia by as much as half1. But a recent meta-analysis including almost 14,000 patients from 53 trials demonstrated that this treatment in fact increases mortality by 17% up to 28 days from the end of the active study phase2. Thus, it is clear that the role of meta-analyses can be crucial in everyday clinical practice. Read more