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Meta-analysis, Evidence-Based Medicine, and Clinical Guidelines

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Essentials of Clinical Research

Abstract

Meta-analysis refers to methods for the systematic review of a set of individual studies (either from the aggregate data or the individual patient data) with the aim to quantitatively combine their results. This has become a popular approach to attempt to answer questions when the results from individual studies have not been definitive. This chapter will discuss meta-analyses and highlight issues that need critical assessment before the results of the meta-analysis are accepted. Some of these critical issues include: publication bias, sampling bias, and study heterogeneity. Evidence-based medicine and clinical practice guidelines are dependent upon meta-analyses to guide their recommendations. Evidence-based medicine is an apt term to the extent that it advocates more reliance on clinical research than on personal experience or intuition; and, has led to a paradigm outlining the “level of evidence” that addresses a particular clinical question (also see Chap. 3). These “levels of evidence” are also utilized by clinical practice guidelines, but “as the number of available guidelines provided by a variety of sources has literally exploded, serious questions and controversies have arisen about how guidelines should be developed, implemented, and evaluated.”

To consult the statistician after an experiment is finished is often merely to ask him to conduct a post mortem examination. He can perhaps say what the experiment died of.

R.A. Fisher. Presidential Address by Professor R.A. Fisher, Sc.D., F.R.S. Sankhyā: The Indian Journal of Statistics (1933–1960), Vol. 4, No. 1 (1938), pp. 14–17. http://www.jstor.org/stable/40383882.

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Authors and Affiliations

  1. Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Ave S MT 638, Birmingham, AL, 35205, USA

    Stephen P. Glasser M.D.

  2. Cardiovascular Division, University of Minnesota Medical School, Minneapolis, MN, USA

    Sue Duval Ph.D.

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  1. Stephen P. Glasser M.D.
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  2. Sue Duval Ph.D.
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Correspondence to Stephen P. Glasser M.D. .

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  1. Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA

    Stephen P. Glasser

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Glasser, S.P., Duval, S. (2014). Meta-analysis, Evidence-Based Medicine, and Clinical Guidelines. In: Glasser, S. (eds) Essentials of Clinical Research. Springer, Cham. https://doi.org/10.1007/978-3-319-05470-4_10

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  • DOI: https://doi.org/10.1007/978-3-319-05470-4_10

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