Are Meta-Analyses a Form of Medical Fake News?
Thoughts About How They Should Contribute to Medical Science and Practice
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How many dreadful manuscripts describing the results of a meta-analysis are submitted to and rejected from journals each year? We cannot know, but many published meta-analyses do not use appropriate methods or contribute meaningfully to medical thought or patient care. Some journals avoid all meta-analyses, whereas others pride themselves on publishing only the best; still others are delighted to have anything to print in an era where the number of opportunities to publish greatly exceeds the number of valid observations.
Many have critically examined the methodology of meta-analysis, and others have set standards for their execution. Despite such guidance, meta-analyses continue to proliferate, but we should ask: do they really contribute? Esteemed organizations regard the conclusions of a well-executed meta-analysis as a higher level of evidence than a single well-done clinical trial. This commentary explains why this cannot possibly be true.
A Meta-Analysis is Only an Imperfect Observational Study
Many physicians believe (incorrectly) that there is something magical about a meta-analysis. A meta-analysis is an observational study, but the author does no original work. Someone simply notices that several articles have data that pertain to a common topic and that they might show similar patterns. How can the patterns be described? In the past, the favored approach was to depict these in a narrative, but this task required insight into the details of each trial and a willingness …