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[Trial sequential analysis : Sample size calculation for reliable meta-analyses]
1Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland. Weibel_S@ukw.de.
Trial Sequential Analysis (TSA) helps reduce random errors in meta-analyses. For breast cancer surgery, TSA indicates regional anesthesia may not significantly reduce pain, unlike initial findings.
Area of Science:
- Medical Statistics
- Evidence-Based Medicine
- Clinical Research Methodology
Background:
- Meta-analyses significantly influence medical decisions.
- Random errors can lead to misinterpretation of intervention effects in meta-analyses.
Purpose of the Study:
- Introduce authors and readers to the issue of random errors in meta-analyses.
- Present Trial Sequential Analysis (TSA) as a method to adjust for random error risks.
Main Methods:
- Illustrated TSA application using regional anesthesia for persistent postoperative pain (POPP) after breast cancer surgery and thoracotomy.
- Compared TSA results with conventional meta-analysis methods.
Main Results:
- Conventional meta-analysis suggested regional anesthesia reduced POPP for both surgery types.
- TSA confirmed sufficient evidence for thoracotomy but indicated potential false positive for breast cancer surgery.
- Current data suggests no significant POPP reduction with regional anesthesia for breast cancer surgery.
Conclusions:
- TSA is a valuable tool for minimizing random error risks in meta-analyses.
- TSA enables a more reliable assessment of evidence supporting meta-analysis findings.
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