Discrepancies between meta-analyses and subsequent large randomized, controlled trials
Discrepancies between meta-analyses and subsequent large randomized, controlled trials
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DOI：
10.1056/nejm199708213370806
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发表时间：
1997-08-21
影响因子：
158.5
通讯作者：
Derderian, F
中科院分区：
文献类型：
--
作者：
LeLorier, J;Gregoire, G;Derderian, F
荟萃分析现在被广泛用于提供证据来支持临床策略。然而，大型随机对照试验被认为是评估临床干预效果的金标准。方法：我们将发表在四种期刊（《新英格兰医学杂志》、《柳叶刀》、《内科医学年鉴》和《美国医学协会杂志》）上的大型随机对照试验（涉及1000名或更多患者）的结果与早期发表的同一主题的荟萃分析结果进行比较。对于主要和次要结局，我们判断随机试验的结果是否与相应的荟萃分析的结果一致，并在常规统计学显著性水平上确定研究结果是阳性（表明治疗改善了结果）还是阴性（表明治疗后的结果与未治疗时相同或更差）(P
Background Meta-analyses are now widely used to provide evidence to support clinical strategies. However, large randomized, controlled trials are considered the gold standard in evaluating the efficacy of clinical interventions.Methods We compared the results of large randomized, controlled trials (involving 1000 patients or more) that were published in four journals (the New England Journal of Medicine, the Lancet, the Annals of Internal Medicine, and the Journal of the American Medical Association) with the results of meta-analyses published earlier on the same topics. Regarding the principal and secondary outcomes, we judged whether the findings of the randomized trials agreed with those of the corresponding meta-analyses, and we determined whether the study results were positive (indicating that treatment improved the outcome) or negative (indicating that the outcome with treatment was the same or worse than without it) at the conventional level of statistical significance (P