Meta-analysis in medical research: potentials and limitations

Zwahlen, Marcel; Renehan, Andrew; Egger, Matthias (2008). Meta-analysis in medical research: potentials and limitations. Urologic oncology - seminars and original investigations, 26(3), pp. 320-9. New York, N.Y.: Elsevier 10.1016/j.urolonc.2006.12.001

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Meta-analysis, the statistical combination of results from several studies to produce a single estimate of a treatment effect or size of an association, continues to attract controversy. We illustrate and discuss the promises and limitations of meta-analysis. Meta-analysis of clinical trials can prevent delays in the introduction of effective treatments or lead to the timely identification of adverse effects. However, meta-analyses are liable to numerous biases, both at the level of the individual study and the selection of studies for inclusion in meta-analysis. The biases and confounding factors that threaten the validity of individual studies will also affect meta-analyses of observational studies. We argue that meta-analyses should only be performed within the framework of systematic reviews that have been prepared using methods that minimize bias and address the combinability of studies.

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