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Related Experiment Videos

Issues in comparisons between meta-analyses and large trials

J P Ioannidis1, J C Cappelleri, J Lau

  • 1National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20852, USA. ji24m@nih.gov

JAMA
|April 18, 1998
PubMed
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Discrepancies between meta-analyses and large trials depend on study selection and endpoint definitions. Careful evaluation of these clinical evidence tools is crucial for medical practice guidance.

Area of Science:

  • Clinical Epidemiology
  • Evidence-Based Medicine

Background:

  • Investigated concordance between meta-analyses and large trials using various protocols.
  • Inconsistent conclusions have raised questions about the reliability of these clinical evidence tools.

Purpose of the Study:

  • To evaluate protocols comparing meta-analyses and large trials.
  • To understand reasons for disagreement in the concordance of these two research methods.

Main Methods:

  • Systematic comparison of protocol designs.
  • Analysis of study selection, agreement definitions, and analysis methods.
  • Examination of reported discrepancies between large trials and meta-analyses.

Main Results:

  • Discrepancies increased when large trials were from influential journals or when secondary endpoints were included.

Related Experiment Videos

  • Agreement varied significantly (kappa 0.22-0.72) based on definition; treatment effect correlation ranged from -0.12 to 0.76.
  • Large trials disagreed with meta-analyses 10-23% of the time when magnitude and uncertainty were considered; attributed to disease risk, protocols, quality, and bias.

    • Conclusions:

    • Study and endpoint selection influence conclusions when comparing large trials and meta-analyses.
    • Critical appraisal of both research methods enhances their utility in guiding medical practice.