Jadad A R, McQuay H J
Oxford Regional Pain Relief Unit, Churchill Hospital, United Kingdom.
J Clin Epidemiol. 1996 Feb;49(2):235-43. doi: 10.1016/0895-4356(95)00062-3.
A systematic search of the literature was performed to identify the maximum possible number of meta-analyses that evaluated analgesic interventions. Seventy-four reports were identified and retrieved and the scientific quality of 80 separate meta-analyses was assessed under blind conditions by 2 judges using Oxman and Guyatt's index. Most of the meta-analyses evaluated pharmacological interventions for chronic pain conditions and two-thirds were published since 1990. Ninety percent of the meta-analyses had methodological flaws that could limit their validity. The main deficiencies were lack of information on methods to retrieve and to assess the validity of primary studies and lack of data on the design of the primary studies. Meta-analyses of low quality produced significantly more positive conclusions. For several topics, different meta-analyses evaluating the same intervention produced conflicting results. The need to resolve these contradictions is highlighted.
我们进行了系统的文献检索，以确定评估镇痛干预措施的荟萃分析的最大可能数量。共识别并检索到74份报告，由两名评判员在盲态条件下使用奥克斯曼和盖亚特指数对80项独立荟萃分析的科学质量进行了评估。大多数荟萃分析评估了慢性疼痛疾病的药物干预措施，其中三分之二是1990年以后发表的。90%的荟萃分析存在可能限制其有效性的方法学缺陷。主要不足在于缺乏关于检索和评估原始研究有效性方法的信息，以及原始研究设计的数据。低质量的荟萃分析得出的阳性结论明显更多。对于几个主题，评估同一干预措施的不同荟萃分析得出了相互矛盾的结果。突出了解决这些矛盾的必要性。
