Is meta-analysis the platinum standard of evidence?
An astonishing volume and diversity of evidence is available for many hypotheses in the biomedical and social sciences. Some of this evidence-usually from randomized controlled trials (RCTs)-is amalgamated by meta-analysis. Despite the ongoing debate regarding whether or not RCTs are the 'gold-standard' of evidence, it is usually meta-analysis which is considered the best source of evidence: meta-analysis is thought by many to be the platinum standard of evidence. However, I argue that meta-analysis falls far short of that standard. Different meta-analyses of the same evidence can reach contradictory conclusions. Meta-analysis fails to provide objective grounds for intersubjective assessments of hypotheses because numerous decisions must be made when performing a meta-analysis which allow wide latitude for subjective idiosyncrasies to influence its outcome. I end by suggesting that an older tradition of evidence in medicine-the plurality of reasoning strategies appealed to by the epidemiologist Sir Bradford Hill-is a superior strategy for assessing a large volume and diversity of evidence.
Department of Philosophy, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0119, USA. jstegeng@ucsd.edu
Jacob
J
Stegenga
D035843:Biomedical Research / Q000592:standards; D003657:Decision Making; D055317:Evidence-Based Practice; D006801:Humans; D015201:Meta-Analysis as Topic; D016032:Randomized Controlled Trials as Topic; D012106:Research / Q000592:standards*; D012961:Sociology / Q000379:methods