Meta-analyses: a method to maximise the evidence from clinical studies?
- Wolfgang MaierAffiliated withDepartment of Psychiatry and Psychotherapy, Rheinische Friedrich-Wilhelms-University Email author
- , Hans-Jürgen MöllerAffiliated withDepartment of Psychiatry and Psychotherapy, Ludwig-Maximilians-University
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Evidence-based medicine (EBM) is becoming the guiding principle for clinical treatment decisions. But evidence remains a loosely defined term. Multiple criteria for evidence criteria have been proposed. Most influential evidence criteria give priority to meta-analyses because they promise an objective procedure to combine the outcomes of all informative, putatively conflicting studies on the same issue in an overall score. However, we claim that meta-analyses are of limited informative value for the following six reasons: (1) meta-analyses are often “overpowered” with clinically irrelevant results that might emerge as highly significant; (2) there is serious concern of publication biases with “negative” studies not being published; (3) meta-analyses consider the variation in the results of the empirical studies included to be random noise, however, the variability of results across studies can be informative; (4) the result of a meta-analysis depends on the strategy used to identify the included empirical studies; (5) the quality of conclusions from meta-analyses depends on the statistical tests used to combine the results of the separate studies; (6) the qualitative conclusions drawn from the meta-analytical combination of individual studies may depend on specific design aspects of the individual studies. Thus, meta-analyses are primarily a method to generate hypotheses through an a posteriori analysis of treatment effects.
KeywordsMeta-analyses Evidence-based medicine Clinical studies
- Meta-analyses: a method to maximise the evidence from clinical studies?
European Archives of Psychiatry and Clinical Neuroscience
- Online Date
- November 2009
- Print ISSN
- Online ISSN
- D. Steinkopff-Verlag
- Additional Links
- Evidence-based medicine
- Clinical studies
- Industry Sectors
- Author Affiliations
- 1. Department of Psychiatry and Psychotherapy, Rheinische Friedrich-Wilhelms-University, Sigmund-Freud-Str. 25, 53105, Bonn, Germany
- 2. Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Nussbaumstr. 7, 80336, Munich, Germany