Feinstein A R
Yale University School of Medicine, New Haven, CT, USA.
Stat Med. 1996 Jun 30;15(12):1273-80; discussion 1281-3. doi: 10.1002/(SICI)1097-0258(19960630)15:12<1273::AID-SIM307>3.0.CO;2-D.
Randomized trials are effective and usually unbiased for showing the average results in a selected outcome variable for treatment A versus treatment B, and meta-analyses produce an average of these averages. The results of both the trials and meta-analyses are often pragmatically unsatisfactory, however, because they do not reflect cogent distinctions desired by practising clinicians in the heterogeneous subgroups formed by diverse components in the patients' baseline states, in proficiency of therapy, and in additional outcome phenomena. If the inadequacies of previous trials have led to performance of a suitable new trial, it should not be stopped by the numbers emerging from meta-analyses of prior non-pertinent results.
随机试验对于显示治疗A与治疗B在选定结果变量上的平均结果是有效的，且通常无偏倚，而荟萃分析则得出这些平均值的平均数。然而，试验和荟萃分析的结果在实际应用中往往不能令人满意，因为它们没有反映出临床医生在由患者基线状态的不同组成部分、治疗熟练度以及其他结果现象所形成的异质子组中所期望的有说服力的差异。如果先前试验的不足导致进行了一项合适的新试验，那么它不应因对先前不相关结果的荟萃分析得出的数据而停止。
