Journal
BRITISH JOURNAL OF ANAESTHESIA
Volume 128, Issue 2, Pages 233-235Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.bja.2021.09.028
Keywords
anaesthesia; bias; clinical trial methodology; meta-analysis; outcomes; postoperative pulmonary complications; rigour
Categories
Funding
- US National Institutes of Health (NIH) [K23DA040923]
- Agency for Healthcare Research and Quality (AHRQ) [R01HS027795]
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Meta-analyses are important for guiding clinical trials and care, but they can be affected by methodologic problems and biases in the underlying trials. Publication bias often leads to overestimation of benefits in small trials, but this can be corrected by subsequent large trials. It is essential to conduct large, robust trials as they are irreplaceable by meta-analyses.
Meta-analyses guide planning of clinical trials and clinical care, but are subject to all the methodologic problems and potential biases present in the underlying trials. Furthermore, publication bias often contributes to overestimated benefit in meta-analyses of small trials, which are often 'corrected' by subsequent large trials. Meta-analyses are no substitute for large robust trials.
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