Factors affecting the comparability of meta-analyses and largest trials results in perinatology
Factors affecting the comparability of meta-analyses and largest trials results in perinatology
复制标题
DOI：
10.1016/s0895-4356(97)00148-0
复制
发表时间：
1997-09-01
影响因子：
7.2
通讯作者：
Donner, A
中科院分区：
文献类型：
--
作者：
Villar, J;Piaggio, G;Donner, A
这份报告的目的是提供一种新的方法来评估Meta分析(MA)在证实大型试验(LT)结果方面的表现，并确定可以解释结果中缺乏相似性的因素。我们使用两个标准来判断MA和LT之间的相似程度：(A)MA的相对风险与LT的相对风险的比率；以及(B)关于该比率的95%的可信区间。此外，这种相似程度与是否有证据选择性地纳入实证研究(例如，发表偏差)进行了交叉列表，这是从“漏斗图”和统计指标判断的。根据使用我们两个标准中的哪一个，我们发现所研究的30个MA中有20%到53%与LT有很高或非常高的相似程度。我们还发现了强有力的证据表明，影响MA不对称漏斗图的因素，如发表偏见，可能在这种相似程度中发挥重要作用。有相当大比例的荟萃分析与大型试验结果不一致。我们建议使用漏斗图作为确定哪些MA可能会误导的工具。然而，考虑到每个主题的随机对照试验数量令人遗憾地很少，手头的统计指标不太可能在许多医学领域中使用。(C)1997年爱思唯尔科学公司。
The objective of this report is to provide a new methodology for evaluating the performance of meta-analysis (MA) in corroborating results of large trials (LT) and to identify factors that could explain lack of similarity in the results. We used two criteria to judge the degree of similarity between a MA and the LT: (a) the ratio of the relative risk of the MA to the relative risk of the LT; and (b) the 95% confidence interval about this ratio. Furthermore, this degree of similarity was cross-tabulated with the presence or not of evidence of selective inclusion of positive studies (e.g., publication bias) as judged from ''funnel plots'' and statistical indicators.Depending on which of our two criteria was used, we found that between 20% and 53% of the 30 MAs studied have high or very high degree of similarity with the LT. We also found strong evidence that factors influencing asymmetrical funnel plots of MA, such as publication bias, may play an important role in this degree of similarity. There was a sizeable proportion of meta analyses that did not agree with large trial results. We recommend that funnel plots be used as a tool for identifying which MAs can mislead. However, the statistical indicators at hand are unlikely to be of use in many areas of medicine considering the regrettably small number of randomized controlled trials per topic available. (C) 1997 Elsevier Science Inc.