Presentation on theme: "Meta-Analyses: Appropriate Growth or Malignant Tumor? Moderator –Alan M. Batterham, FACSM University of Teesside, Middlesbrough, United Kingdom. Speakers."— Presentation transcript:
Meta-Analyses: Appropriate Growth or Malignant Tumor? Moderator –Alan M. Batterham, FACSM University of Teesside, Middlesbrough, United Kingdom. Speakers –Will G. Hopkins, FACSM AUT University, Auckland, New Zealand. –Ian Shrier, FACSM McGill University, Montreal, PQ, Canada.
Historical Notes Karl Pearson (1857-1936) –Many of the groups … are far too small to allow of any definite opinion being formed at all, having regard to the size of the probable error involved (Report on certain enteric fever inoculation statistics. BMJ, 3, 1243-6, 1904)
Historical Notes Gene Glass the first to coin the term Meta Analysis in 1976 (Primary, secondary, and meta-analysis of research. Educat Res, 5, 3-8) 1979 – Archie Cochrane (1909- 1988) highlighted that healthcare decision makers had no ready access to reliable evidence reviews. Cochrane Collaboration launched 1993
DEFINITIONS Systematic ReviewSystematic Review –A review of a clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise relevant research, and to collect and analyse data from the studies that are included in the review. Meta-AnalysisMeta-Analysis –The use of statistical techniques (quantitative inference) in a systematic review to integrate the results of included studies. Sometimes misused as a synonym for systematic reviews, where the review includes a meta-analysis.
DEFINITIONS Non-Systematic Review: Non-systematic selection of studies, no statistical combination - may be biased.Non-Systematic Review: Non-systematic selection of studies, no statistical combination - may be biased. – Take a simmering topic, extract the juice of an argument, add the essence of one filing cabinet, sprinkle liberally with your own publications and sift out the work of noted detractors or adversaries (Anon.) –An opinion piece
REVIEWS SYST. REVIEWS SYST. REVIEWS Cochrane- defined meta-analysis Cochrane- defined meta-analysis BIASED ESTIMATES META ANALYSES
COCHRANE REVIEWS 0 200 400 600 800 1000 1200 199519961997199819992000200120022003200420052006 Year # Published in Year Protocol Reviews
Number of articles with Meta Analysis in the title: ISI Web of Science
Fig 1 The Cochrane symbol, seen here in plans for the façade of the Cochranite Vatican that is to be built in Summertown Clinicians for the Restoration of Autonomous Practice Writing Group (BMJ, 325, 1496-1498, 2002)
EBM factions (BMJ, 325, 1496-1498) Cochranites - members of a worldwide order that has Archie Cochrane as its patron saint. They worship systematic reviews Metaanophiles - a heretical spin off of the Cochranites, who believe in combining the results of all the randomised controlled trials in the universe. Their current estimate of the ultimate summary statistic is 42 (95% CI 41.9999 to 42.0001)