What is Meta-Analysis?
Why is Meta-Analysis Important?
The Scope and Depth of Meta-Analysis
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What is Meta-Analysis?
· Meta-analysis is a method of systematically selecting relevant
primary research on a specific therapy, appraising its quality, and synthesizing
the results to arrive at a clear summary conclusion: is a particular
therapy effective or not?
· Also called research synthesis, overview, or pooled analysis.
· All meta-analyses start with a systematic review in which medical
databases around the world are searched to identify every known published
article on the specific topic of interest.
· The systematic review helps avoid biased conclusions that may
result if important papers are left out of the analysis.
· Meta-analysis is now considered a prerequisite for the National
Institutes of Health (NIH) and other large research grants for clinical
trials. With our meta-analysis program, the Pine Street Foundation is
laying the important groundwork for future clinical trials and research
in the field of integrative care.
· Systematic review and meta-analysis are not the same thing. Although
every meta-analysis starts with a systemic search, the results yielded
in the search are not always combinable. Studies that are too different
(because they have widely dissimilar results) shouldn't be combined into
the same meta-analysis. Look for the "p-value" in the study...this
number represents the probability of arriving at the same conclusions
by chance alone. If the p-value for the test of heterogeneity is less
than 0.20 or 0.10 (there is currently some debate as to what the cut-off
should be), then there is too much variation between the studies found
in the systematic review and they should not be statistically combined
for meta-analysis.
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Why is Meta-Analysis Important?
· Provides an efficient overview of the types of patients, treatment
details, and exact results of each of the individual studies covered
in the meta-analysis.
· Provides an easily understandable synthesis (or summary) of the
results of a large number of published individual studies, which would
otherwise take months to locate and read.
· Allows the reader the opportunity to appreciate in one concise
report how much (or how little) work has been done on a particular medical
question, resulting in a birds-eye view of the current state of knowledge.
· Clearly identifies what next steps should be taken in the scientific
evolution of research on a specific medical problem, highlighting what
questions the "next generation" trial should ask.
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The Scope and Depth of Meta-Analysis
· Our meta-analysis on chronic hepatitis B, published in 2002,
systematically reviewed 587 studies and yielded 27 that matched our criteria
of randomized controlled trials that investigated this specific clinical
question, "does adding Chinese herbal medicine to alpha interferon
improve treatment outcomes, as compared to interferon alone?"
· Our meta-analysis on non-small cell lung cancer, currently in
progress, will review 1,305 studies and will likely yield over 100 matches
for analysis. Our specific research question is, "do patients with
non-small cell lung cancer, using Chinese herbal medicine in combination
with Taxol/Carboplatin chemotherapy, have better short-term results,
lower toxicity, and better long-term survival than those patients using
the same chemotherapy alone?"
· The first step of any meta-analysis is to systematically search
medical databases worldwide to identify all known published studies on
the clinical question being asked. Thus, meta-analysis is not only large
in terms of the numbers of studies being analyzed but it also establishes
a broad overview or a "current state of knowledge" summary
of medical progress to date.
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