Department of Medical Informatics, ERA-EDTA Registry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Kidney Int. 2009 Dec;76(11):1130-6. doi: 10.1038/ki.2009.339. Epub 2009 Sep 2.
Systematic reviews and meta-analyses are increasingly popular study designs in clinical research. A systematic review is a summary of the medical literature that uses explicit and reproducible methods for searching the literature and critical appraisal of individual studies; in contrast, a meta-analysis is a mathematical synthesis of the results of these individual studies. These study designs can be useful tools for summarizing the increasing amount of knowledge that is gained from scientific papers on a certain topic. In addition, combining individual studies in a meta-analysis increases statistical power, resulting in more precise effect estimates. Although the specific methodology of systematic reviews includes steps to minimize bias in all stages of the process, investigators should be aware of potential biases such as poor quality of included studies, heterogeneity between studies, and the presence of publication and outcome reporting bias. This paper explains how systematic reviews and meta-analyses should be performed and how to interpret and implement their results. In addition, we discuss when meta-analyses are useful and when they are not.
系统评价和荟萃分析在临床研究中越来越受欢迎。系统评价是对医学文献的总结，它使用明确和可重复的方法来搜索文献和对个体研究进行评价；相比之下，荟萃分析是对这些个体研究结果的数学综合。这些研究设计可以成为总结从某个主题的科学论文中获得的越来越多知识的有用工具。此外，荟萃分析中合并个体研究可以增加统计效力，从而得出更精确的效果估计。虽然系统评价的具体方法包括在整个过程的各个阶段减少偏倚的步骤，但研究人员应该意识到潜在的偏倚，如纳入研究的质量差、研究之间的异质性以及存在发表和结果报告偏倚。本文解释了如何进行系统评价和荟萃分析，以及如何解释和实施其结果。此外，我们还讨论了何时进行荟萃分析是有用的，以及何时不是。
