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A Practical Guide to Writing (and Understanding) a Scientific Paper: Meta-Analyses

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Basic Methods Handbook for Clinical Orthopaedic Research

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Abstract

Meta-analyses represent an unbiased way of summarising the evidence on a specific topic. A meta-analysis is a formal process for gathering and evaluating literature to answer a specific question, using statistics to combine the data from randomised controlled trials. However, their use is controversial, as there are several critical conditions and methodological considerations that could produce misleading conclusions. A wide and extensive systematic search, clear-cut inclusion criteria and appropriate data extraction are mandatory when it comes to obtaining all the evidence relating to the investigated topic. Statistical analyses should be performed carefully and all sources of heterogeneity should be explored to avoid dangerous bias. The design and the quality of the included studies should be clearly presented to show the reader the overall quality of the evidence that is presented in the meta-analysis. Finally, the results should be interpreted critically from both a clinical and a statistical point of view.

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Author information

Authors and Affiliations

  1. Dipartimento Scienze Biomediche e Neuromotorie DIBINEM, Università di Bologna, Bologna, Italy

    Alberto Grassi

  2. IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

    Alberto Grassi & Stefano Zaffagnini

  3. SIGASCOT Arthroscopy Committee, Florence, Italy

    Alberto Grassi

  4. Società Italiana del Ginocchio Artroscopia Sport Cartilagine Tecnologie Ortopediche (SIGASCOT) Arthroscopy Committee, Florence, Italy

    Riccardo Compagnoni & Corrado Bait

  5. 1st Department, Azienda Socio Sanitaria Territoriale Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy

    Riccardo Compagnoni & Pietro Randelli

  6. Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Kristian Samuelsson

  7. Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden

    Kristian Samuelsson

  8. Istituto Clinico Villa Aprica, Como, Italy

    Corrado Bait

  9. Laboratori di Biomeccanica e Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Bologna, Italy

    Stefano Zaffagnini

Authors
  1. Alberto Grassi
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  2. Riccardo Compagnoni
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  3. Kristian Samuelsson
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  4. Pietro Randelli
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  5. Corrado Bait
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  6. Stefano Zaffagnini
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Corresponding author

Correspondence to Alberto Grassi .

Editor information

Editors and Affiliations

  1. UPMC Rooney Sports Complex, University of Pittsburgh, Pittsburgh, PA, USA

    Volker Musahl

  2. Department of Orthopaedics, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden

    Jón Karlsson

  3. Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Laufen und Liestal), Bruderholz, Switzerland

    Michael T. Hirschmann

  4. McMaster University, Hamilton, ON, Canada

    Olufemi R. Ayeni

  5. Hospital for Special Surgery, New York, NY, USA

    Robert G. Marx

  6. Department of Orthopaedic Surgery, NorthShore University HealthSystem, Evanston, IL, USA

    Jason L. Koh

  7. Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan

    Norimasa Nakamura

Appendix: Internet Links and Websites Useful for the Various Steps in Preparing a Meta-Analysis

Appendix: Internet Links and Websites Useful for the Various Steps in Preparing a Meta-Analysis

Appendix: useful links

Guides to meta-analyses

Cochrane Handbook for Systematic Review of Interventions

http://handbook.cochrane.org/

PRISMA Guidelines for Systematic Reviews and Meta-Analyses

http://www.prisma-statement.org/

GRADE Handbook

http://gdt.guidelinedevelopment.org/app/handbook/handbook.html

Databases

Cochrane Library

http://www.thecochranelibrary.com

PubMed

https://www.ncbi.nlm.nih.gov/pubmed/

Embase

http://store.elsevier.com/embase

Clinical Trials Database

https://clinicaltrials.gov/

Statistical software

Cochrane RevMan

http://tech.cochrane.org/revman/download

OpenMetaAnalyst

http://www.cebm.brown.edu/openmeta/download.html

MedCalc

https://www.medcalc.org/download.php

Methodological evaluation

Oxford Level of Evidence

http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/

JBJS Level of Evidence

http://jbjs.org/level-of-evidence

Newcastle-Ottawa Scale for Non-randomised Studies

http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp

Modified Newcastle-Ottawa Scale

http://www.uphs.upenn.edu/cep/methods/Modified%20Newcastle-Ottawa.pdf

CONSORT checklist for randomised controlled trials (RCT)

http://www.consort-statement.org/

PEDRO scale for randomised controlled trials (RCT)

https://www.pedro.org.au/english/downloads/pedro-scale/

AMSTAR score for systematic reviews

https://amstar.ca/Amstar_Checklist.php

COSMIN guidelines for studies of measurement instrument

http://www.cosmin.nl/downloads.html (for studies of measurement instruments)

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Grassi, A., Compagnoni, R., Samuelsson, K., Randelli, P., Bait, C., Zaffagnini, S. (2019). A Practical Guide to Writing (and Understanding) a Scientific Paper: Meta-Analyses. In: Musahl, V., et al. Basic Methods Handbook for Clinical Orthopaedic Research. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-58254-1_47

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  • DOI: https://doi.org/10.1007/978-3-662-58254-1_47

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