[元分析--以麻醉和疼痛医学为例进行解释]。

Die Anaesthesiologie Pub Date : 2024-10-01 Epub Date: 2024-09-23 DOI:10.1007/s00101-024-01460-y
Petra Bäumler, Dominik Irnich
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引用次数: 0

摘要

荟萃分析是系统综述的核心部分。荟萃分析一词是指用统计方法总结现有科学研究结果,以提供尽可能多的证据。在医学领域,荟萃分析旨在指导临床决策。本文概述了必要的工作步骤。经典的荟萃分析总结了将干预措施与对照干预措施进行比较的随机对照试验的结果。本文以 Cochrane 综述中关于视频喉镜与直接喉镜的比较为例进行说明。文章的第二部分重点介绍了荟萃分析的两种扩展方法:单个患者数据荟萃分析和网络荟萃分析。单个患者数据荟萃分析利用的是从纳入研究的患者层面数据中获得的信息。例如,本文介绍了一个国际合作项目在针灸治疗慢性疼痛疗效方面所完成的工作。网络荟萃分析不仅可以利用现有的直接证据,还可以利用各自的间接证据,对两种以上的干预措施进行比较。科克伦综述》对术后恶心和呕吐的预防药物进行了说明。
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[Meta-analyses-Explained my means of examples from anesthesia and pain medicine].

Meta-analyses are a central part of systematic reviews. The term meta-analysis describes the statistical methods to summarize the results of the available scientific studies providing the highest possible evidence. In medicine, meta-analyses aim to guide clinical decisions. This article provides an overview of the necessary work steps.The classical meta-analysis summarizes the results of randomized controlled trials that compare an intervention against a control intervention. This is illustrated by means of an example from a Cochrane Review on videolaryngoscopy in comparison to direct laryngoscopy. Crucial methodological aspects such as the weighting of individual studies when pooling their results as well as the evaluation of study heterogeneity and potential publication bias are explained.The second part of the article focusses on two extensions of meta-analyses: the individual patient data meta-analysis and the network meta-analysis. The individual patient data meta-analysis makes use of the information that is available from the patient-level data of the included studies. As an example, the work accomplished by an international collaboration on the efficacy of acupuncture in chronic pain is presented. A network meta-analysis enables the comparison of more than two interventions by making use not only of the available direct but also of the respective indirect evidence. This is illustrated by means of a Cochrane Review on drugs for the prophylaxis of postoperative nausea and vomiting.

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