Gerber Stefan, Tallon Deborah, Trelle Sven, Schneider Martin, Jüni Peter, Egger Matthias
Department of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, CH-3012 Berne, Switzerland.
J Clin Epidemiol. 2007 Aug;60(8):773-80. doi: 10.1016/j.jclinepi.2006.10.022. Epub 2007 Mar 26.
To assess the methodology of meta-analyses published in leading general and specialist medical journals over a 10-year period.
Volumes 1993-2002 of four general medicine journals and four specialist journals were searched by hand for meta-analyses including at least five controlled trials. Characteristics were assessed using a standardized questionnaire.
A total of 272 meta-analyses, which included a median of 11 trials (range 5-195), were assessed. Most (81%) were published in general medicine journals. The median (range) number of databases searched increased from 1 (1-9) in 1993/1994 to 3.5 (1-21) in 2001/2002, P<0.0001. The proportion of meta-analyses including searches by hand (10% in 1993/1994, 25% in 2001/2002, P=0.005), searches of the grey literature (29%, 51%, P=0.010 by chi-square test), and of trial registers (10%, 32%, P=0.025) also increased. Assessments of the quality of trials also became more common (45%, 70%, P=0.008), including whether allocation of patients to treatment groups had been concealed (24%, 60%, P=0.001). The methodological and reporting quality was consistently higher in general medicine compared to specialist journals.
Many meta-analyses published in leading journals have important methodological limitations. The situation has improved in recent years but considerable room for further improvements remains.
评估在10年期间发表于主要综合性和专科医学期刊上的Meta分析方法。
通过手工检索1993 - 2002年4种综合性医学期刊和4种专科期刊，查找包含至少5项对照试验的Meta分析。使用标准化问卷评估其特征。
共评估了272项Meta分析，其中位试验数为11项（范围5 - 195项）。大多数（81%）发表于综合性医学期刊。检索数据库的中位（范围）数量从1993/1994年的1个（1 - 9个）增加到2001/2002年的3.5个（1 - 21个），P<0.0001。包含手工检索（1993/1994年为10%，2001/2002年为25%，P = 0.005）、灰色文献检索（分别为29%、51%，经卡方检验P = 0.010）和试验注册库检索（分别为10%、32%，P = 0.025）的Meta分析比例也有所增加。对试验质量的评估也变得更为常见（分别为45%、70%，P = 0.008），包括患者分配至治疗组是否被隐匿（分别为24%、60%，P = 0.001）。与专科期刊相比，综合性医学期刊的方法学和报告质量始终更高。
发表于主要期刊上的许多Meta分析存在重要的方法学局限性。近年来情况有所改善，但仍有很大的进一步改进空间。
