Meta-analysis: Methods, strengths, and weaknesses

International Institute for Drug Development, Brussels, Belgium.
Oncology (Williston Park, N.Y.) (Impact Factor: 2.32). 04/2000; 14(3):437-43; discussion 444, 447.
Source: PubMed


Meta-analysis is a systematic, quantitative approach to the combination of data from several clinical trials that address the same question. This analytic approach can help resolve questions that remain unclear from the results of individual trials. Meta-analysis is of particular interest in oncology because of the small differences in efficacy between therapeutic alternatives. The large number of patients included in meta-analyses permit small to moderate benefits of a treatment to be reliably detected and larger treatment benefits to be quantified more accurately. Despite these apparent benefits, the use of meta-analysis has met with a great deal of resistance and has generated much controversy in clinical journals. After a brief description of the basic methods of conducting meta-analyses, this article will explore both their advantages and disadvantages.

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    • "In the latter case the meta-analysis integrates all available publications in the literature and aggregates their available results in order to answer a question. Individual patient data meta-analysis must be considered superior, given that it permits analysts to evaluate the reliability of the randomization methods used, to check the validity of the data, to redone the original analyses to perform subgroup analyses not conducted by the original collectors of the data, and to use different statistical methods [21]. The purpose of the present paper is to focus on the role of meta-analyses in optimization of chemotherapeutic treatment for patients with advanced/metastatic NSCLC. "
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    ABSTRACT: Despite the fact that Non-Small Cell Lung Cancer (NSCLC) represents the leading cause of cancer-related death in the western, after two decades of intensive clinical research, there still remains a substantial lack of consensus regarding the appropriate chemotherapeutic management of patients with advanced stage disease. For patients with metastatic disease and good performance status, what is considered "standard" treatment is a platinum-based doublet. Several meta-analyses have been performed in order to answer several questionable issues in the treatment of these patients. Their conclusions could be used as an effective instrument for resolving various clinical questions, such as advantage of chemotherapy for advanced NSCLC and identification of the most active combinations and most active agents, or treatment duration and thus providing more reliable evidence for clinical practice.
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    New England Journal of Medicine 11/2001; 345(17):1276; author reply 1278-9. · 55.87 Impact Factor
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