| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
American Journal of Epidemiology Vol. 140, No. 3: 290-296
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
Invited Commentary: A Critical Look at Some Popular Meta-Analytic Methods
From the Department of Epidemiology, University of California at Los Angeles School of Public Health Los Angeles, CA
Correspondence to Dr Sander Greenland, 1720 Tuna Canyon Rd , Topanga, CA 90290
Meta-analysis is essential for obtaining reproducible summaries of study results and valuable for discovering patterns among study results. A good meta-analysis will highlight and delineate the subjective components of these processes and vigorously search for sources of heterogeneity. Unfortunately, these objectives are not always met by common techniques. For example, a scatterplot is an objective summarization if the data are uncensored, but inferred patterns should be regarded as subjective recognitions of the analyst, not objective data properties. Random-effects summaries encourage averaging over important data patterns, divert attention from key sources of heterogeneity, and can amplify distortions produced by publication bias; such summaries should only be used when important heterogeneity remains after a thorough search for the sources of such heterogeneity. Quality scoring adds the analyst's subjective bias to the results, wastes information, and can prevent the recognition of key sources of heterogeneity; it should be completely replaced by meta-regression on quality items (the score components). Am J Epidemiol 1994; 140:290–6.
data interpretation; statistical; epidemiologic methods; meta-analysis; models; statistical; quality scores; statistics
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. Liberati, D. G. Altman, J. Tetzlaff, C. Mulrow, P. C. Gotzsche, J. P.A. Ioannidis, M. Clarke, P. J. Devereaux, J. Kleijnen, and D. Moher The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration Ann Intern Med, August 18, 2009; 151(4): W-65 - W-94. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. J. Lean, A. R. Rabiee, T. F. Duffield, and I. R. Dohoo Invited review: Use of meta-analysis in animal health and reproduction: Methods and applications J Dairy Sci, August 1, 2009; 92(8): 3545 - 3565. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Liberati, D. G Altman, J. Tetzlaff, C. Mulrow, P. C Gotzsche, J. P A Ioannidis, M. Clarke, P J Devereaux, J. Kleijnen, and D. Moher The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration BMJ, July 21, 2009; 339(jul21_1): b2700 - b2700. [Abstract] [Full Text]
|
|
|
|
 |
|
 J. Koreth, R. Schlenk, K. J. Kopecky, S. Honda, J. Sierra, B. J. Djulbegovic, M. Wadleigh, D. J. DeAngelo, R. M. Stone, H. Sakamaki, et al. Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia in First Complete Remission: Systematic Review and Meta-analysis of Prospective Clinical Trials JAMA, June 10, 2009; 301(22): 2349 - 2361. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Termine, V. Panzarella, S. Falaschini, A. Russo, D. Matranga, L. Lo Muzio, and G. Campisi HPV in oral squamous cell carcinoma vs head and neck squamous cell carcinoma biopsies: a meta-analysis (1988-2007) Ann. Onc., October 1, 2008; 19(10): 1681 - 1690. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A E Ades, N. J Welton, D. Caldwell, M. Price, A. Goubar, and G. Lu Multiparameter evidence synthesis in epidemiology and medical decision-making J Health Serv Res Policy, October 1, 2008; 13(suppl_3): 12 - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. V. Peter, P. John, P. L Graham, J. L Moran, I. A. George, and A. Bersten Corticosteroids in the prevention and treatment of acute respiratory distress syndrome (ARDS) in adults: meta-analysis BMJ, May 3, 2008; 336(7651): 1006 - 1009. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Schomig, A. Dibra, S. Windecker, J. Mehilli, J. Suarez de Lezo, C. Kaiser, S.-J. Park, J.-J. Goy, J.-H. Lee, E. Di Lorenzo, et al. A Meta-Analysis of 16 Randomized Trials of Sirolimus-Eluting Stents Versus Paclitaxel-Eluting Stents in Patients With Coronary Artery Disease J. Am. Coll. Cardiol., October 2, 2007; 50(14): 1373 - 1380. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Bonovas, K. Filioussi, C. S. Flordellis, and N. M. Sitaras Statins and the Risk of Colorectal Cancer: A Meta-Analysis of 18 Studies Involving More Than 1.5 Million Patients J. Clin. Oncol., August 10, 2007; 25(23): 3462 - 3468. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Manheimer, K. Linde, L. Lao, L. M. Bouter, and B. M. Berman Meta-analysis: Acupuncture for Osteoarthritis of the Knee Ann Intern Med, June 19, 2007; 146(12): 868 - 877. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Bonovas and N. M. Sitaras Does pravastatin promote cancer in elderly patients? A meta-analysis Can. Med. Assoc. J., February 27, 2007; 176(5): 649 - 654. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Bonovas, K. Filioussi, N. Tsavaris, and N. M. Sitaras Statins and Cancer Risk: A Literature-Based Meta-Analysis and Meta-Regression Analysis of 35 Randomized Controlled Trials J. Clin. Oncol., October 20, 2006; 24(30): 4808 - 4817. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Kubo and D. A. Corley Body Mass Index and Adenocarcinomas of the Esophagus or Gastric Cardia: A Systematic Review and Meta-analysis. Cancer Epidemiol. Biomarkers Prev., May 1, 2006; 15(5): 872 - 878. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Danchin, M. Cucherat, C. Thuillez, E. Durand, Z. Kadri, and P. G. Steg Angiotensin-Converting Enzyme Inhibitors in Patients With Coronary Artery Disease and Absence of Heart Failure or Left Ventricular Systolic Dysfunction: An Overview of Long-term Randomized Controlled Trials. Arch Intern Med, April 10, 2006; 166(7): 787 - 796. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Huxley, F. Barzi, and M. Woodward Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies BMJ, January 14, 2006; 332(7533): 73 - 78. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Bonovas, K. Filioussi, N. Tsavaris, and N. M. Sitaras Use of Statins and Breast Cancer: A Meta-Analysis of Seven Randomized Clinical Trials and Nine Observational Studies J. Clin. Oncol., December 1, 2005; 23(34): 8606 - 8612. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Kastrati, A. Dibra, S. Eberle, J. Mehilli, J. Suarez de Lezo, J.-J. Goy, K. Ulm, and A. Schomig Sirolimus-Eluting Stents vs Paclitaxel-Eluting Stents in Patients With Coronary Artery Disease: Meta-analysis of Randomized Trials JAMA, August 17, 2005; 294(7): 819 - 825. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-D. Gaudreau, P. Gagnon, M.-A. Roy, F. Harel, and A. Tremblay Association Between Psychoactive Medications and Delirium in Hospitalized Patients: A Critical Review Psychosomatics, August 1, 2005; 46(4): 302 - 316. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. R. Rabiee, I. J. Lean, and M. A. Stevenson Efficacy of Ovsynch Program on Reproductive Performance in Dairy Cattle: A Meta-Analysis J Dairy Sci, August 1, 2005; 88(8): 2754 - 2770. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Rubinstein, S. M. Peerdeman, M. W. van Tulder, I. Riphagen, and S. Haldeman A Systematic Review of the Risk Factors for Cervical Artery Dissection Stroke, July 1, 2005; 36(7): 1575 - 1580. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. P Moja, E. Telaro, R. D'Amico, I. Moschetti, L. Coe, A. Liberati, and on behalf of the Metaquality Study Group Assessment of methodological quality of primary studies by systematic reviews: results of the metaquality cross sectional study BMJ, May 7, 2005; 330(7499): 1053. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. S. Gorin and J. E. Heck Meta-Analysis of the Efficacy of Tobacco Counseling by Health Care Providers Cancer Epidemiol. Biomarkers Prev., December 1, 2004; 13(12): 2012 - 2022. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Hashibe, P. Brennan, R. C. Strange, R. Bhisey, I. Cascorbi, P. Lazarus, M. B. O. Ophuis, S. Benhamou, W. D. Foulkes, T. Katoh, et al. Meta- and Pooled Analyses of GSTM1, GSTT1, GSTP1, and CYP1A1 Genotypes and Risk of Head and Neck Cancer Cancer Epidemiol. Biomarkers Prev., December 1, 2003; 12(12): 1509 - 1517. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. L. Hjalgrim, T. Westergaard, K. Rostgaard, K. Schmiegelow, M. Melbye, H. Hjalgrim, and E. A. Engels Birth Weight as a Risk Factor for Childhood Leukemia: A Meta-Analysis of 18 Epidemiologic Studies Am. J. Epidemiol., October 15, 2003; 158(8): 724 - 735. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. S. Linet, S. Wacholder, and S. H. Zahm Interpreting Epidemiologic Research: Lessons From Studies of Childhood Cancer Pediatrics, July 1, 2003; 112(1): 218 - 232. [Full Text] [PDF]
|
|
|
|
|
|
K. Hoffmann, A. Kroke, K. Klipstein-Grobusch, and H. Boeing Standardization of Dietary Intake Measurements by Nonlinear Calibration Using Short-term Reference Data Am. J. Epidemiol., November 1, 2002; 156(9): 862 - 870. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Kanaya, D. Grady, and E. Barrett-Connor Explaining the Sex Difference in Coronary Heart Disease Mortality Among Patients With Type 2 Diabetes Mellitus: A Meta-analysis Arch Intern Med, August 12, 2002; 162(15): 1737 - 1745. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Maldonado and S. Greenland Estimating causal effects Int. J. Epidemiol., April 1, 2002; 31(2): 422 - 429. [Full Text] [PDF]
|
|
|
|
|
|
E. S Ford, S J. Smith, D. F Stroup, K. K Steinberg, P. W Mueller, and S. B Thacker Homocyst(e)ine and cardiovascular disease: a systematic review of the evidence with special emphasis on case-control studies and nested case-control studies Int. J. Epidemiol., February 1, 2002; 31(1): 59 - 70. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A Furukawa, G. H Guyatt, and L. E Griffith Can we individualize the 'number needed to treat'? An empirical study of summary effect measures in meta-analyses Int. J. Epidemiol., February 1, 2002; 31(1): 72 - 76. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Song, K. S Khan, J. Dinnes, and A. J Sutton Asymmetric funnel plots and publication bias in meta-analyses of diagnostic accuracy Int. J. Epidemiol., February 1, 2002; 31(1): 88 - 95. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. A Fischbach, K. J Goodman, M. Feldman, and C. Aragaki Sources of variation of Helicobacter pylori treatment success in adults worldwide: a meta-analysis Int. J. Epidemiol., February 1, 2002; 31(1): 128 - 139. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Legler, H. I. Meissner, C. Coyne, N. Breen, V. Chollette, and B. K. Rimer The Effectiveness of Interventions To Promote Mammography among Women with Historically Lower Rates of Screening Cancer Epidemiol. Biomarkers Prev., January 1, 2002; 11(1): 59 - 71. [Abstract] [Full Text]
|
|
|
|
 |
|
 T. B. Starr Significant Shortcomings of the U.S. Environmental Protection Agency's Latest Draft Risk Characterization for Dioxin-Like Compounds Toxicol. Sci., November 1, 2001; 64(1): 7 - 13. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. L. B. J. Lucassen, W. J. J. Assendelft;, M. M. Garrison, and D. A. Christakis Systematic Review of Treatments for Infant Colic Pediatrics, October 1, 2001; 108(4): 1047 - 1048. [Full Text] [PDF]
|
|
|
|
 |
|
 M Delgado-Rodriguez, M Ruiz-Canela, J De Irala-Estevez, J Llorca, and M A Martinez-Gonzalez Participation of epidemiologists and/or biostatisticians and methodological quality of published controlled clinical trials J Epidemiol Community Health, August 1, 2001; 55(8): 569 - 572. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Song, T. A. Sheldon, A. J. Sutton, K. R. Abrams, and D. R. Jones Methods for Exploring Heterogeneity in Meta-Analysis Eval Health Prof, June 1, 2001; 24(2): 126 - 151. [Abstract] [PDF]
|
|
|
|
|
|
M. S. Sandhu, I. R. White, and K. McPherson Systematic Review of the Prospective Cohort Studies on Meat Consumption and Colorectal Cancer Risk: A Meta-Analytical Approach Cancer Epidemiol. Biomarkers Prev., May 1, 2001; 10(5): 439 - 446. [Abstract] [Full Text]
|
|
|
|
|
|
S. Hernandez-Diaz and L. A. G. Rodriguez Association Between Nonsteroidal Anti-inflammatory Drugs and Upper Gastrointestinal Tract Bleeding/Perforation: An Overview of Epidemiologic Studies Published in the 1990s Arch Intern Med, July 24, 2000; 160(14): 2093 - 2099. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A W M van der Windt, E. Thomas, D. P Pope, A. F de Winter, G. J Macfarlane, L. M Bouter, and A. J Silman Occupational risk factors for shoulder pain: a systematic review Occup. Environ. Med., July 1, 2000; 57(7): 433 - 442. [Abstract] [Full Text]
|
|
|
|
 |
|
 J. Villar and J. M Belizan Same nutrient, different hypotheses: disparities in trials of calcium supplementation during pregnancy Am. J. Clinical Nutrition, May 1, 2000; 71(5): 1375S - 1379. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. F. Stroup, J. A. Berlin, S. C. Morton, I. Olkin, G. D. Williamson, D. Rennie, D. Moher, B. J. Becker, T. A. Sipe, S. B. Thacker, et al. Meta-analysis of Observational Studies in Epidemiology: A Proposal for Reporting JAMA, April 19, 2000; 283(15): 2008 - 2012. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. SMYTH, S. WALTERS, R. SMYTH;, K. MCCAFFERY, R. E OLVER, M. FRANKLIN, and S. MUKHOPADHYAY Systematic review of antistaphylococcal antibiotic therapy in cystic fibrosis Thorax, March 1, 2000; 55(3): 251 - 251. [Full Text]
|
|
|
|
|
|
J. A. Berlin and D. Rennie Measuring the Quality of Trials: The Quality of Quality Scales JAMA, September 15, 1999; 282(11): 1083 - 1085. [Full Text] [PDF]
|
|
|
|
|
|
R. D. Hull, R. F. Brant, G. F. Pineo, P. D. Stein, G. E. Raskob, and K. A. Valentine Preoperative vs Postoperative Initiation of Low-Molecular-Weight Heparin Prophylaxis Against Venous Thromboembolism in Patients Undergoing Elective Hip Replacement Arch Intern Med, January 25, 1999; 159(2): 137 - 141. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Greenwald Role of Dietary Fat in the Causation of Breast Cancer: Point Cancer Epidemiol. Biomarkers Prev., January 1, 1999; 8(1): 3 - 7. [Full Text]
|
|
|
|
 |
|
 S. Gao, H. C. Hendrie, K. S. Hall, and S. Hui The Relationships Between Age, Sex, and the Incidence of Dementia and Alzheimer Disease: A Meta-analysis Arch Gen Psychiatry, September 1, 1998; 55(9): 809 - 815. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. B. Ruige, W. J. J. Assendelft, J. M. Dekker, P. J. Kostense, R. J. Heine, and L. M. Bouter Insulin and Risk of Cardiovascular Disease : A Meta-Analysis Circulation, March 17, 1998; 97(10): 996 - 1001. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Frericks, J. Kievit, J. M. van Baalen, and J. H. van Bockel Carotid Recurrent Stenosis and Risk of Ipsilateral Stroke : A Systematic Review of the Literature Stroke, January 1, 1998; 29(1): 244 - 250. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. D. Hull, G. E. Raskob, R. F. Brant, G. F. Pineo, and K. A. Valentine Relation Between the Time to Achieve the Lower Limit of the APTT Therapeutic Range and Recurrent Venous Thromboembolism During Heparin Treatment for Deep Vein Thrombosis Arch Intern Med, December 8, 1997; 157(22): 2562 - 2568. [Abstract] [PDF]
|
|
|
|
|
|
R. D. Hull, G. E. Raskob, R. F. Brant, G. F. Pineo, and K. A. Valentine The Importance of Initial Heparin Treatment on Long-term Clinical Outcomes of Antithrombotic Therapy: The Emerging Theme of Delayed Recurrence Arch Intern Med, November 10, 1997; 157(20): 2317 - 2321. [Abstract] [PDF]
|
|
|
|
|
|
M. A. Klebanoff, R. J. Levine, and R. DerSimonian Large Trials vs Meta-analysis of Smaller Trials JAMA, February 5, 1997; 277(5): 376 - 377. [Abstract] [PDF]
|
|
|
|
|
|
J. C. Cappelleri, J. P. A. Ioannidis, C. H. Schmid, and J. Lau Large Trials vs Meta-analysis of Smaller Trials-Reply JAMA, February 5, 1997; 277(5): 377 - 378. [Abstract] [PDF]
|
|
|
|
|
|
K. S. Khan, S. Daya, and A. R. Jadad The Importance of Quality of Primary Studies in Producing Unbiased Systematic Reviews Arch Intern Med, March 25, 1996; 156(6): 661 - 666. [Abstract] [PDF]
|
|
|
|
|
|
D. Wieland, A. E. Stuck, A. L. Siu, J. adams, and L. Z. Rubenstein Meta-Analytic Methods for Health Services Research: An Example from Geriatrics Eval Health Prof, September 1, 1995; 18(3): 252 - 282. [Abstract] [PDF]
|
|
|
|
|
|
K. F. Schulz, I. Chalmers, R. J. Hayes, and D. G. Altman Empirical Evidence of Bias: Dimensions of Methodological Quality Associated With Estimates of Treatment Effects in Controlled Trials JAMA, February 1, 1995; 273(5): 408 - 412. [Abstract] [PDF]
|
|