title: Underutilization of Meta-analysis in Diagnostic Pathology.
abstract: BACKGROUND
  Underutilization of Meta-analysis No studies to our knowledge have investigated citations and utilization of meta-analysis in diagnostic pathology (DP).
  
  
  OBJECTIVE
  To characterize meta-analyses in DP compared with meta-analyses in medicine.
  
  
  METHODS
  We searched PubMed for meta-analyses in 12 major DP journals without specifying years and in 4 major medicine journals in both 2006 and 2011. We compared articles' adjusted citation ratios (ACRs), defined as an article's citation count divided by the mean citations for the meta-analysis, review, and original research articles published in the same journal in the same year.
  
  
  RESULTS
  Forty-one of 76 DP articles, 74 of 125 medicine articles in 2011, and 52 of 83 medicine articles in 2006 were qualified meta-analyses as identified by PubMed. The ACRs of DP meta-analysis articles were higher than those of original research articles (2.62 ± 2.31 versus 0.92 ± 0.84, P < .001) and similar to those of review articles in 2006 (2.62 ± 2.31 versus 1.95 ± 1.59, P = .50), but they were similar to both in 2011 (1.85 ± 1.39 versus 0.99 ± 1.43, P = .11; 1.85 ± 1.39 versus 1.12 ± 1.43, P = .21, respectively). Diagnostic pathology and medicine meta-analyses had similar ACRs (1.85 ± 1.39 versus 1.57 ± 1.35 in 2011, P = .60; and 2.62 ± 2.31 versus 1.85 ± 1.90 in 2006, P = .50, respectively). However, although DP journals published fewer meta-analyses (0.97% versus 6.66% in 2011 and 0.67% versus 4.40% in 2006, P < .001 for both), they published more meta-analyses using both original and published data than medicine (21.95% versus 1.59%, P < .001). They also published more meta-analyses per year in 2011-2014 than in 2000-2010 (6.4 ± 1.29 versus 1.36 ± 1.03 articles per year, P < .001).
  
  
  CONCLUSIONS
  We found underutilization of meta-analyses in DP, despite their high ACRs and recently increased utilization. More DP meta-analyses are needed.
authors.affiliation: From Colgate University, Hamilton, New York (Mr Kinzler); and the Department of Pathology, University Medical Center of Princeton, Plainsboro, New Jersey, the Department of Chemical Biology, Ernest Mario School of Pharmacy, the Department of Pathology, Robert Wood Johnson Medical School, and Cancer Institute of New Jersey, Rutgers University, Piscataway, New Jersey (Dr Zhang).
authors.forename: Michael
authors.initials: M
authors.lastname: Kinzler
authors.forename: Lanjing
authors.initials: L
authors.lastname: Zhang
mesh_terms: D006801:Humans; D015201:Meta-Analysis as Topic; D010338:Pathology, Clinical / Q000592:standards / Q000706:statistics & numerical data*; D039781:PubMed / Q000592:standards / Q000706:statistics & numerical data*