Journal
JOURNAL OF CLINICAL EPIDEMIOLOGY
Volume 67, Issue 12, Pages 1309-1319Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jclinepi.2014.08.007
Keywords
Multiple-indication reviews; Panoramic meta-analyses; Research methods; Detecting unintended effects; Evaluating effectiveness; Overviews; Assessing harms
Funding
- National Institute for Health Research (NIHR)
- CLAHRC West Midlands
- Engineering and Physical Sciences Research Council (EPSRC) Multidisciplinary Assessment of Technology Centre for Healthcare (MATCH) program (EPSRC) [GR/S29874/01]
- Medical Research Council Midland Hub for Trials Methodology Research program (MRC) [G0800808]
- Cancer Research UK [C5529]
- National Institute for Health and Care Excellence (External Assessment Centre) [572]
- NIHR Surgical Reconstruction and Microbiology Research Centre (SRMRC)
- MRC [G0800808] Funding Source: UKRI
- Cancer Research UK [16895] Funding Source: researchfish
- Engineering and Physical Sciences Research Council [GR/S29874/01] Funding Source: researchfish
- Medical Research Council [G0800808] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0611-10008] Funding Source: researchfish
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Objectives: To describe the use of systematic reviews or overviews (systematic reviews of systematic reviews) to synthesize quantitative evidence of intervention effects across multiple indications (multiple-indication reviews) and to highlight issues pertaining to such reviews. Study Design and Setting: MEDLINE was searched from 2003 to January 2014. We selected multiple-indication reviews of interventions of allopathic medicine that included evidence from randomized controlled trials. We categorized the subject areas evaluated by these reviews and examined their methodology. Utilities and caveats of multiple-indication reviews are illustrated with examples drawn from published literature. Results: We retrieved 52 multiple-indication reviews covering a wide range of interventions. The method has been used to detect unintended effects, improve precision by pooling results across indications, and examine scientific hypotheses across disease classes. Conclusion: Systematic reviews of interventions are typically used to evaluate the effects of treatments, one indication at a time. Here, we argue that, with due attention to methodological caveats, much can be learned by comparing the effects of a given treatment across many related indications. (C) 2014 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/3.0/).
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