临床试验的meta分析

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1、542-11-#1Statistics542IntroductiontoClinicalTrialsMetaAnalysis542-11-#2Meta-AnalysisAlternatives?OccasionallyComplementary?YesMeta-AnalysisCombinationofsimilarstudiesusingsimilarsubjectsandsimilartreatmentsandsimilaroutcomes542-11-#3Figure2OddsRatios

2、and95%ConfidenceLimitsforVariousStudiesandaPooledEstimate542-11-#4NewMethodofAnalyzingHealthDataStirsDebatebyLawrenceK.AltmanIncreasinguseofacontroversialstatisticalmethodtoevaluatemedicaltherapiesandsurgicalproceduresisbeginningtoaffectprofoundlytheca

3、reofpregnantwomenandpatientswithcancer,heartdiseaseandmanyothercommonconditions.Themethod,knownasmeta-analysispromisestoplananincreasinglyimportantroleindetermininghealthrisks,environmentalhazardsandnationalpolicyonpaymentformedicalcare.Backerssaytechniq

4、uecandrawbig,reliableconclusionsfromsmall,inconsistentfindings.Meta-analysisisatermderivedfromtheGreekmeaningananalysisthatismorecomprehensive.Thelargernumbersobtainedbycombiningstudiesprovideagreaterstatisticalpowerthananyoftheindividualstudies.Research

5、ersareoftenabletodrawmorereliableinferencesornewconclusionsfromthecombinedresultsthanfromthesmallerstudiesthatmaybeinconclusiveindividually.Inearlierapplicationsofmeta-analysis,researchersevaluatedintelligencequotients,governmentsocialwelfareprogramsandm

6、anyothertopics.Meta-analysishascometomedicinelate,but“itisnowundergoingaboominpopularity,”saidDr.ThomasC.Chalmers,adistinguishedphysicianoftheDepartmentofVeteransAffairsinBostonandapioneerinmethodology.Themethodinvolvesananalysisofpreviousanalyses.Itcomb

7、inestheresultsofawiderangeofexistingsmallerstudiesandthenappliesoneofseveralstatisticaltechniquestodiscovermorepreciselywhatisknownfrompreviousresearch.Itmayalsoproduceaunifiedresultfromdiverse,apparentlycontradictorystudies.Thetechniquehasalreadyshednew

8、lightontheeffectivenessofmedicaltherapies.Althoughithasnot,initself,revolutionizedanymedicaltreatmentithashelpedclearawaytheconfusioncausedbystudieswithscatteredandapparentlyconflictingfindingsandhasstrengthenandconfirmedf