James H. Lubowitz M.D. (Editor-in-Chief), Mark P. Cote P.T., D.P.T., M.S.C.T.R. (Deputy Editor, Statistics)
{"title":"Meta-analysis of Nonrandomized Controlled Trials Is Rarely Justified: Systematic Reviews Must Avoid Improper Pooling","authors":"James H. Lubowitz M.D. (Editor-in-Chief), Mark P. Cote P.T., D.P.T., M.S.C.T.R. (Deputy Editor, Statistics)","doi":"10.1016/j.arthro.2024.09.039","DOIUrl":null,"url":null,"abstract":"<div><div>Systematic reviews of the literature, as compared with original scientific articles, are the easiest types of studies to perform, and using contemporary meta-analysis software, the press of a button yields a “pooled weighted mean” (averaging the outcomes of the included articles and adjusting for sample size). The results seem conclusive. However, if included studies are not homogeneous and/or are of lower quality (high risk of bias), which is typical of nonrandomized trials, synthesis in a meta-analysis is not recommended, and quantitative pooling of nonrandomized studies is improper. In addition, by exploring clinical and methodologic differences (heterogeneity) between studies included in a systematic review, we discover and reveal reasons for the differences in outcomes among studies. This allows us to more accurately inform individual patient care and future research.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 2","pages":"Pages 155-159"},"PeriodicalIF":4.4000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0749806324007564","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Systematic reviews of the literature, as compared with original scientific articles, are the easiest types of studies to perform, and using contemporary meta-analysis software, the press of a button yields a “pooled weighted mean” (averaging the outcomes of the included articles and adjusting for sample size). The results seem conclusive. However, if included studies are not homogeneous and/or are of lower quality (high risk of bias), which is typical of nonrandomized trials, synthesis in a meta-analysis is not recommended, and quantitative pooling of nonrandomized studies is improper. In addition, by exploring clinical and methodologic differences (heterogeneity) between studies included in a systematic review, we discover and reveal reasons for the differences in outcomes among studies. This allows us to more accurately inform individual patient care and future research.
期刊介绍：
Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
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