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Meta-analysis as Evidence

Meta-analysis as Evidence Opinion Editorials represent the opinions of the authors and JAMA EDITORIAL and not those of the American Medical Association. Building a Better Pyramid Jesse A. Berlin, ScD; Robert M. Golub, MD In following the practice of evidence-based medicine, when ponents (eg, diversity in patient populations or interventions) faced with a question about prevention or treatment the cli- and statistical components (eg, random differences). There are nician should seek out the best evidence that addresses the statistical approaches to try to quantify some elements of question. If quality of evi- heterogeneity, including the Q statistic (a measure of total dence is considered a pyra- within-study variance), the I statistic (the ratio of variability mid, what category should of results among studies to total observed variation), and τ Related article page 623 be placed at the peak? One (a measure of between-studies variance). Heterogeneity can dogma argues that it is the best-conducted randomized clini- be investigated and sometimes managed, but not eliminated cal trial (RCT) comprising patients similar to those seen by as an issue. In some instances, helpful insights can be gained the clinician, reasoning that a well-done RCT mimics pure when the heterogeneity of findings of component studies can http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Meta-analysis as Evidence

JAMA , Volume 312 (6) – Aug 13, 2014

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Publisher
American Medical Association
Copyright
Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2014.8167
pmid
25117128
Publisher site
See Article on Publisher Site

Abstract

Opinion Editorials represent the opinions of the authors and JAMA EDITORIAL and not those of the American Medical Association. Building a Better Pyramid Jesse A. Berlin, ScD; Robert M. Golub, MD In following the practice of evidence-based medicine, when ponents (eg, diversity in patient populations or interventions) faced with a question about prevention or treatment the cli- and statistical components (eg, random differences). There are nician should seek out the best evidence that addresses the statistical approaches to try to quantify some elements of question. If quality of evi- heterogeneity, including the Q statistic (a measure of total dence is considered a pyra- within-study variance), the I statistic (the ratio of variability mid, what category should of results among studies to total observed variation), and τ Related article page 623 be placed at the peak? One (a measure of between-studies variance). Heterogeneity can dogma argues that it is the best-conducted randomized clini- be investigated and sometimes managed, but not eliminated cal trial (RCT) comprising patients similar to those seen by as an issue. In some instances, helpful insights can be gained the clinician, reasoning that a well-done RCT mimics pure when the heterogeneity of findings of component studies can

Journal

JAMAAmerican Medical Association

Published: Aug 13, 2014

References