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Meta-analysis: an update

H S Sacks1, D Reitman, D Pagano

  • 1Thomas C. Chalmers Clinical Trials Unit, Mount Sinai School of Medicine of CUNY, New York, USA.

The Mount Sinai Journal of Medicine, New York
|May 1, 1996
PubMed
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Meta-analysis research quality has improved, but methodological standards need enhancement. Further work is required in literature searching, trial quality assessment, and result synthesis for better scientific discovery.

Area of Science:

  • Medical Research Methodology
  • Evidence Synthesis

Background:

  • Meta-analysis, a method for combining study results, has evolved significantly.
  • Previous surveys in 1987 and 1992 assessed the quality of meta-analyses.

Purpose of the Study:

  • To evaluate the methodological quality of published meta-analyses.
  • To identify trends in meta-analysis quality over time.
  • To highlight areas needing improvement in meta-analysis conduct.

Main Methods:

  • A scoring system with 23 items across six areas (study design, combinability, bias control, statistical analysis, sensitivity analysis, results application) was used.
  • Quality scores were analyzed for meta-analyses published in different time periods (1955-1982, 1983-1986, 1987-1990).

Main Results:

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  • The mean number of satisfactorily addressed items increased significantly from 7.63 (1955-1982) to 11.91 (1987-1990).
  • Methodological quality of meta-analyses has shown definite improvement over the surveyed periods.
  • Despite improvements, significant deficiencies remain in key areas.

Conclusions:

  • While meta-analysis methodology has advanced, critical areas like literature searching, trial quality evaluation, and result synthesis require urgent attention.
  • The expansion of meta-analysis to non-randomized studies necessitates ongoing attention to methodological standards and unresolved issues.