Koch A, Ziegler S
Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM), Berlin.
Med Klin (Munich). 2000 May;95(1 Spec No):83-90.
In these days, more than one clinical trial is mostly performed to evaluate a new treatment or therapeutic intervention. This necessitates a combined evaluation of their results. An integration of evidence from several trials is also helpful to determine the actual knowledge. These are the main goals of meta-analyses. Since the end of the 80s meta-analyses are widely used in clinical research. At the beginning of a meta-analysis, a protocol has to be developed. Similar to a protocol of a clinical trial, the inclusion and exclusion criteria for trials, the hypotheses and the planned analyses have to be fixed. After a careful localization of trials, a combined statistical analysis is performed. An investigation of heterogeneity, i.e., differences between study results, is indispensable. During the last years, the tool meta-analysis has been criticized. The criticism mainly results from poorly conducted meta-analyses which generated results without prespecifying hypotheses or which merely combined study results. Well-planned meta-analyses, on the contrary, have an increasing influence in clinical research.
如今,大多会开展不止一项临床试验来评估一种新的治疗方法或治疗性干预措施。这就需要对其结果进行综合评估。整合来自多项试验的证据也有助于确定实际的知识情况。这些就是荟萃分析的主要目标。自80年代末以来,荟萃分析在临床研究中得到了广泛应用。在开展荟萃分析之初,必须制定一个方案。与临床试验方案类似,必须确定试验的纳入和排除标准、假设以及计划进行的分析。在对试验进行仔细定位之后,要进行综合统计分析。对异质性(即研究结果之间的差异)的调查是必不可少的。在过去几年里,荟萃分析这一工具受到了批评。批评主要源于进行得很糟糕的荟萃分析,这些分析得出的结果没有预先设定假设,或者只是简单地合并了研究结果。相反,精心规划的荟萃分析在临床研究中的影响力越来越大。