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Meta-analyses of randomized controlled trials.

H S Sacks, J Berrier, D Reitman

    The New England Journal of Medicine
    |February 19, 1987
    PubMed
    Summary
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    This study assessed 86 meta-analyses, finding most lacked comprehensive quality evaluation. Improved methods are needed for literature searching, trial quality assessment, and synthesizing results.

    Area of Science:

    • Medical research methodology
    • Evidence synthesis

    Background:

    • Meta-analysis is a research method combining results from multiple studies.
    • Randomized controlled trials (RCTs) are a key source for meta-analyses.

    Purpose of the Study:

    • To evaluate the quality of published meta-analyses of randomized controlled trials.
    • To identify areas for methodological improvement in meta-analysis.

    Main Methods:

    • Systematic literature search for English-language meta-analyses of RCTs.
    • Quality assessment using a 23-item scoring system across six domains.
    • Analysis of the number of quality items addressed by each meta-analysis.

    Main Results:

    • Eighty-six meta-analyses were identified and evaluated.

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  • Only 28% of meta-analyses addressed all six quality assessment areas.
  • The average number of satisfactorily addressed quality items was 7.7 out of 23.
  • Conclusions:

    • A significant need exists for enhancing meta-analysis methodology.
    • Improvements are required in literature searching, trial quality appraisal, and result synthesis.
    • Current meta-analyses often exhibit suboptimal methodological rigor.