Basics of Systematic Reviews and Meta-Analyses for the Nephrologist

Abstract

Renal practitioners are expected to apply the best available evidence from rigorous scientific research to clinical decision-making and also for policy-making for those involved. Advances in information technology and unprecedented access to data have simplified the process for the search of best available evidence to guide practice. However, it is challenging to cope with the increasing volume of publications in nephrology and other areas of medicine. Accordingly, systematic reviews and meta-analysis have greatly facilitated best practice and effective clinical decision-making. Conducting a systematic review/meta-analysis involves a number of steps that start with protocol development and research question formulation, design and study selection criteria, followed by retrieval of potentially relevant studies, selection of those studies to be included and evaluation of a study’s risk of bias. Systematic reviews and meta-analyses have both strengths and weaknesses. Many of the perceived limitations of meta-analysis are not inherent in the methodology, but actually represent deficits in the conduct or reporting of individual primary studies. With the continuous proliferation of published renal clinical studies, such publications will continue to be an important resource for clinicians and researchers in nephrology. It is therefore important for nephrologists to keep abreast of developments in this field, which requires some knowledge about how these studies are conducted, reported and how to appraise them for application to clinical practice or policy-making.

The Role of Zinc in Cardiovascular Disease

“…Lobo et al showed that zinc is negatively associated with lipid peroxidation (LDL) and inflammatory markers like TNF alpha (TNF-alpha) and CRP, which were independently associated with CV mortality. 35 However, zinc deficiency was not found to be associated with higher risks of clinical outcomes including all-cause death, CV events, and infections in a study by Tonelli et al 38…”

Znanost temeljena na dokazima u nefrologiji, dijalizi i transplantaciji bubrega

“…Od ukupnog broja publiciranih studija do 2008. godine svega 10 % randomiziranih kliničkih studija je bilo sažeto u sustavnim preglednim člancima (1.000 od dotad postojećih 10.000 randomiziranih kliničkih studija) 9 . No, da bi publicirane studije bile bliske prosječnom čitatelju -nefrologu, kao i sustavni pregledni članci, publicirano je nekoliko članaka koji se bave tematikom kako kritički sagledati kliničke studije u nefrologiji, što tražiti u metaanalizama te kako koristiti sustavne pregledne članke [16][17][18] .…”