Skip to main content
SpringerLink
Log in

Trends in Meta-Analysis

  • Biostatistics
  • Published:
Drug information journal : DIJ / Drug Information Association Aims and scope Submit manuscript

Abstract

While meta-analysis is a well-accepted tool in evidence-based medicine, both the science and the utility of meta-analysis continue to evolve in response to the empirical demands of health care providers, researchers, payers, and policymakers. Three important developments in meta-analysis are summarized, with relevant examples provided for illustration.

First, the indications for performing metaanalyses using aggregate data versus individual patient data are discussed. Second, the advantages of cumulating data in real time as new studies are finished, that is, cumulative meta-analysis, are reviewed. Third, we describe the use of meta-analyses to provide indirect comparisons of various interventions when no head-to-head trials exist. Network meta-analyses, in particular, are a valid way to rank order the efficacy or safety of multiple interventions simultaneously.

Those who use clinical research syntheses should appreciate these highly relevant developments in the field of meta-analysis, developments that hold great promise for all who wish to use information better in health care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cook DJ, Mulrow CD, Haynes RB. Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med. 1997;126:376–380.

    Article  CAS  Google Scholar 

  2. JAMA. Users’ guides interactive. Available at: https://doi.org/pubs.ama-assn.org/misc/usersguides.dtl. Accessed January 30, 2008.

  3. Centre for Evidence-Based Medicine. Available at: https://doi.org/www.cebm.net. Accessed January 30, 2008.

  4. The Cochrane Collaboration. Cochrane Handbook for Systematic Reviews of Interventions. Available at: https://doi.org/www.cochrane.org/resources/handbook/. Accessed January 30, 2008.

  5. Allen IE, Olkin I. Estimating time to conduct a meta-analysis from number of citations retrieved. JAMA. 1999;282:634–635.

    Article  CAS  Google Scholar 

  6. Steinberg K, Smith S, Stroup D, et al. Comparison of effect estimates from a meta-analysis of summary data from published studies and from a meta-analysis using individual patient data for ovarian cancer studies. Am J Epidemiol. 1997;145:917–925.

    Article  CAS  Google Scholar 

  7. Stewart LA, Parmar MB. Meta-analysis of the literature or of individual patient data: is there a difference? Lancet. 1993;341:418–422.

    Article  CAS  Google Scholar 

  8. Berlin JA, Colditz GA. The role of meta-analysis in the regulatory process for foods, drugs, and devices. JAMA. 1999;281:830–834.

    Article  CAS  Google Scholar 

  9. Antman EM, Lau J, Kupelnick B, Mosteller F, Chalmers TC. A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts. Treatments for myocardial infarction. JAMA. 1992;268:240–248.

    Article  CAS  Google Scholar 

  10. Lau J, Schmid CH, Chalmers TC. Cumulative meta-analysis of clinical trials builds evidence for exemplary medical care. J Clin Epidemiol. 1995;48:45–57.

    Article  CAS  Google Scholar 

  11. Juni P, Nartey L, Reichenbach S, et al. Risk of cardiovascular events and rofecoxib: cumulative meta-analysis. Lancet. 2004;364:2021–2029.

    Article  CAS  Google Scholar 

  12. Design, rationale, and baseline characteristics of the Prospective Pravastatin Pooling (PPP) project: a combined analysis of three large-scale randomized trials: Long-Term Intervention With Pravastatin in Ischemic Disease (LIPID). Cholesterol and Recurrent Events (CARE), and West of Scotland Coronary Prevention Study (WOSCOPS). Am J Cardiol. 1995;76:899–905.

  13. Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267–1278.

    Article  CAS  Google Scholar 

  14. Province MA, Hadley EC, Hornbrook MC, et al. The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques. JAMA. 1995;273:1341–1347.

    Article  CAS  Google Scholar 

  15. Diener HC, the Executive Steering Committee on behalf of the SPORTIF III and V Investigators. Stroke prevention using the oral direct thrombin inhibitor Ximelagatran in patients with non-valvular atrial fibrillation: pooled analysis from the SPORTIF III and V studies. Cerebrovasc Dis. 2006;21:279–293.

    Article  CAS  Google Scholar 

  16. Berger JO. Bayesian analysis: a look at today and thoughts of tomorrow. J Am Stat Assoc. 2000;95:1269–1276.

    Article  Google Scholar 

  17. Berry D. Bayesian statistics. Med Decis Making. 2006;26:429–430.

    Article  Google Scholar 

  18. Raudenbush SW, Bryk AS. Empirical Bayes meta-analysis. J Edu Stat. 1985;10:78–98.

    Google Scholar 

  19. Spiegelhalter DJ, Myles JP, Jones DR, Abrams KR. An introduction to Bayesian methods in health technology assessment. BMJ. 1999;319:508–512.

    Article  CAS  Google Scholar 

  20. Schmid CH. Using Bayesian inference to perform meta-analysis. Eval Health Prof. 2001;24:165–189.

    Article  CAS  Google Scholar 

  21. Tunis S, Sheinhait IA, Schmid C, Bishop DJ, Ross SD. The efficacy of lansoprazole compared to histamine-2 receptor antagonists in healing gastric ulcers: a meta-analysis. Clin Ther. 1997;19:743–757.

    Article  CAS  Google Scholar 

  22. Bucher HC, Guyatt GH, Griffith LE, Walter SD. The results of direct and indirect treatment comparisons in meta-analysis of randomized controlled trials. J Clin Epidemiol. 1997;50:683–691.

    Article  CAS  Google Scholar 

  23. McAlister FA, Laupacis A, Wells GA, Sackett DL, for the Evidence-Based Medicine Working Group. Users’ guides to the medical literature: XIX. Applying clinical trial results; B. Guidelines for determining whether a drug is exerting (more than) a class effect. JAMA. 1999;282:1371–1377.

    Article  CAS  Google Scholar 

  24. Caldwell DM, et al. Simultaneous comparison of multiple treatments: combining direct and indirect evidence. BMJ. 2005;331:897–900.

    Article  Google Scholar 

  25. Ross S, Klawansky S, Allen IE. Indirect comparisons of drugs using meta-analysis: validation of results. Value in Health. 2001;4:55.

    Article  Google Scholar 

  26. Topol EJ, Moliterno DJ, Herrmann HC, et al. Comparison of two platelet glycoprotein IIb/IIIa inhibitors, tirofiban and abciximab, for the prevention of ischemic events with percutaneous coronary revascularization. N Eng J Med. 2001;344:1888–1894.

    Article  CAS  Google Scholar 

  27. Eliot W, Mayer P. Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis. Lancet. 2007;369:201–207.

    Article  Google Scholar 

  28. Lu G, Ades AE. Combination of direct and indirect evidence in mixed treatment comparisons. Stat Med. 2004;23:3105–3114.

    Article  CAS  Google Scholar 

  29. Lumley T. Network meta-analysis for indirect treatment comparisons. Stat Med. 2002;21:2313–2324.

    Article  Google Scholar 

  30. Glenny AM, Altman DG, Song F, et al. Indirect comparisons of competing interventions. Health Technol Assess. 2005;9:1–148.

    Article  CAS  Google Scholar 

  31. Psaty BM, Lumley T, Furberg CD. Health outcomes associated with various antihypertensive therapies used as first-line agents: a network meta-analysis. JAMA. 2003;289:2534–2544.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. SDRoss Consulting, 720 Jerusalem Rd., 02025, Cohasset, Massachusetts, USA

    Susan D. Ross MD, FRCPC

Authors
  1. Susan D. Ross MD, FRCPC
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Susan D. Ross MD, FRCPC.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ross, S.D. Trends in Meta-Analysis. Ther Innov Regul Sci 43, 171–176 (2009). https://doi.org/10.1177/009286150904300208

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1177/009286150904300208

Key Words

Search

Navigation