From the Systematic Review Initiative, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom.
Circ Res. 2016 Apr 15;118(8):1264-72. doi: 10.1161/CIRCRESAHA.115.307540.
Controversies from basic science, discrepancies from clinical trials, and divergent results from meta-analyses have recently arisen in the field of cell therapies for cardiovascular repair and regeneration. Noticeably, there are almost as many systematic reviews and meta-analyses published as there are well-conducted clinical studies. But how do we disentangle the confusion they have raised? This article addresses why results obtained from systematic reviews and meta-analyses of human cell-based cardiac regeneration therapies are still valid to inform the design of future clinical trials. It also addresses how meta-analyses are not free from limitations and how important it is to assess the quality of the evidence and the quality of the systematic reviews and finally how stronger conclusions can be drawn when several pieces of evidence converge.
近年来,心血管修复和再生细胞治疗领域出现了许多基础科学争议、临床试验差异以及荟萃分析结果分歧。值得注意的是,发表的系统评价和荟萃分析几乎与精心设计的临床研究一样多。但是,我们如何理清它们所引发的困惑呢?本文探讨了为什么基于人类细胞的心脏再生治疗的系统评价和荟萃分析结果仍然有效,可以为未来临床试验的设计提供信息。它还探讨了荟萃分析并非没有局限性,评估证据质量和系统评价质量的重要性,以及当几条证据汇聚时如何得出更有力的结论。