Sacks H S, Reitman D, Pagano D, Kupelnick B
Thomas C. Chalmers Clinical Trials Unit, Mount Sinai School of Medicine of CUNY, New York, USA.
Mt Sinai J Med. 1996 May-Sep;63(3-4):216-24.
A fairly new type of research, termed meta-analysis, attempts to analyze and combine the results of previous reports. In 1992 we updated our 1987 survey of 86 meta-analyses of randomized control trial reports in the english language literature with an additional 78. We evaluated the quality of these meta-analyses using a scoring method that lists 23 items in six major areas: study design, combinability, control of bias, statistical analysis, sensitivity analysis, and application of results. Of the 23 individual items, the mean number satisfactorily addressed was 7.63 +/- 2.84 (mean +/- S.D.) for 40 papers published from 1955 through 1982, 6.80 +/- 3.86 for 66 papers published from 1983 through 1986, and 11.91 +/- 4.79 for 58 papers published from 1987 through 1990 (F = 31.3, p < .001). We noted that methodology has definitely improved since our first survey of meta-analyses, but an urgent need still exists for a better search of the literature, quality evaluation of trials, and a synthesis of the results. Recently, meta-analysis has expanded to cover non-randomized studies, including evaluation of diagnostic tests and pooling of epidemiologic studies. There is growing concern for standards, and several methodologic issues remain unresolved.
一种相当新的研究类型，称为荟萃分析，试图分析并整合先前报告的结果。1992年，我们更新了1987年对英语文献中86项随机对照试验报告的荟萃分析调查，新增了78项。我们使用一种评分方法评估这些荟萃分析的质量，该方法在六个主要领域列出了23项内容：研究设计、可合并性、偏倚控制、统计分析、敏感性分析以及结果应用。在这23项单独内容中，1955年至1982年发表的40篇论文中得到满意解决的平均数量为7.63±2.84（均值±标准差），1983年至1986年发表的66篇论文为6.80±3.86，1987年至1990年发表的58篇论文为11.91±4.79（F = 31.3，p <.001）。我们注意到，自我们首次对荟萃分析进行调查以来，方法学确实有所改进，但仍迫切需要更好地检索文献、评估试验质量以及综合结果。最近，荟萃分析已扩展到涵盖非随机研究，包括诊断试验评估和流行病学研究汇总。对标准的关注日益增加，并且几个方法学问题仍未得到解决。
