Syrian Board in Orthodontics, Private Practice, Damascus, Syria.
Private Practice, Dara, Syria.
Eur J Orthod. 2023 Nov 30;45(6):802-807. doi: 10.1093/ejo/cjad049.
Meta-analysis (MA) is a common mathematical method used in systematic reviews (SRs) to gather data from different studies. MA may result in overestimation or underestimation of the effect due to systematic and random errors. Trial sequential analysis (TSA) has been used to overcome the limitations of conventional MA. The objective of this study was to re-evaluate the findings of orthodontic MAs using TSA to investigate the conclusiveness of the effect and to estimate the required information size (IS).
Orthodontic SRs with MA published between 1 January 2013 and 31 December 2022 in the leading orthodontic journals were sourced. Data from arm-level MAs were extracted and re-entered in TSA software.
A total of 180 papers were assessed against the inclusion criteria. Finally, 50 SRs with MAs were included. TSA found that almost half of the MAs with significant results demonstrated firm evidence of effect. While 38% of the significant MAs confirmed potentially spurious evidence of effect. In contrast, only one MA with insignificant findings showed a lack of effect. Furthermore, a larger number of patients were needed when the evidence of the effect was absent.
TSA revealed that many orthodontic MAs have potentially false-positive results and have insufficient IS.
荟萃分析（MA）是系统评价（SR）中常用的数学方法，用于从不同研究中收集数据。MA 可能由于系统和随机误差而导致效应的高估或低估。试验序贯分析（TSA）已被用于克服传统 MA 的局限性。本研究的目的是使用 TSA 重新评估正畸 MA 的研究结果，以调查效应的确定性，并估计所需的信息量（IS）。
检索了 2013 年 1 月 1 日至 2022 年 12 月 31 日期间在主要正畸期刊上发表的具有 MA 的正畸 SR。从手臂水平 MA 中提取数据并重新输入 TSA 软件。
共有 180 篇论文符合纳入标准。最终，纳入了 50 篇具有 MA 的 SR。TSA 发现，近一半具有显著结果的 MA 显示出效应的确定证据。而 38%的具有显著效应的 MA 证实了潜在的虚假效应证据。相比之下，只有一个具有无显著效应的 MA 显示缺乏效应。此外，当效应证据不存在时，需要更多的患者。
TSA 显示，许多正畸 MA 可能存在假阳性结果，并且信息量不足。
