Using metaanalysis to evaluate evidence: practical tips and traps.
Although practising evidence-based medicine is the goal of most physicians, it can be a real challenge to sift through the vast body of data to determine the best strategies. Most clinical guidelines regard replicated randomized controlled trials (RCTs), metaanalyses, and systematic reviews as the highest level of evidence to support treatment recommendations. High-quality metaanalyses can overcome many of the drawbacks of individual RCTs and qualitative reviews. They can reduce bias, provide adequate power to demonstrate real differences in outcomes, and resolve the results of inconsistent studies. This paper focuses on basic principles and terms used in metaanalysis, so that clinicians can appropriately evaluate and use their results to guide treatment decisions.
Lam
Raymond W
RW
Division of Clinical Neuroscience, Department of Psychiatry, University of British Columbia, Vancouver. r.lam@ubc.ca
Kennedy
Sidney H
SH
D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use; D003511:Cyclohexanols / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy; D004311:Double-Blind Method; D019317:Evidence-Based Medicine; D006801:Humans; D015201:Meta-Analysis as Topic; D010043:Outcome and Process Assessment, Health Care; D016032:Randomized Controlled Trials as Topic; D016574:Seasonal Affective Disorder / Q000188:drug therapy; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D014196:Trazodone / Q000627:therapeutic use; D000069470:Venlafaxine Hydrochloride
D018687:Antidepressive Agents, Second-Generation; D016642:Bupropion; D003511:Cyclohexanols; D017367:Selective Serotonin Reuptake Inhibitors; D014196:Trazodone; D000069470:Venlafaxine Hydrochloride