Meta-analysis: A practical decision making tool for surgeons

INTERNATIONAL JOURNAL OF SURGERY

卷:7

Review

Panesar, Sukhmeet S.²  Bhandari, Mohit³  Darzi, Ara¹  Athanasiou, Thanos¹ 

[1] Univ London Imperial Coll Sci Technol & Med, Div Surg Oncol Reprod Biol & Anaesthet, London W2 1NY, England

[2] NPSA, London W1T 5HD, England

[3] McMaster Univ, Hamilton, ON L8S 4L8, Canada

关键词: Evidence;    Meta-analysis;    Systematic review;    Surgery;   

DOI  :  10.1016/j.ijsu.2009.05.004

来源: Elsevier

【 摘 要 】

Background: The exponential rise in published medical research on a yearly basis demands a method to summarise best evidence towards its application to patient care in clinical practice. A robust meta-analysis is a valid tool. It is often considered to be a simple process of pooling results from different studies. This is not true. It appears that surgeons lack a reference guide to help them conduct and appraise a meta-analysis. Methods: This paper provides a structural framework to perform a meta-analysis. It guides the surgeon on a journey from identification of the correct clinical question to data analysis and through to producing a structured report. Statistical methods are discussed briefly as most commercial software calculates most results in the background. An example of a recent meta-analysis is given. However, important caveats are mentioned as there are limitations of the meta-analytical technique. Conclusion: Whereas meta-analyses of homogeneous studies are the highest form of evidence, poorly conducted meta-analyses create confusion and serve to harm the patient. Surgeons practising their art in an era of evidence-based surgery need to understand the principles of meta-analyses. (C) 2009 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

【 授权许可】

Free