Detecting the effects of thromboprophylaxis: the case of the rogue reviews

Petticrew, Mark; Kennedy, Susan C

doi:10.1136/bmj.315.7109.665

Cited by 15 publications

(9 citation statements)

References 28 publications

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“…As proposed by Holmes, there are four main indicators of a sound review: (i) a comprehensive literature search; (ii) explicit, detailed, inclusion and exclusion criteria; (iii) a detailed assessment of the quality of the included studies; and (iv) appropriate methods for pooling the data. These indicators, also known as the “Sign of Four”, were observed in our work.…”

Section: Discussionmentioning

confidence: 99%

Estimation of the risk factors for falls in the elderly: Can meta‐analysis provide a valid answer?

Bloch

Thibaud

Tournoux-Facon

et al. 2012

Geriatrics Gerontology Int

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The objective of this study was to analyze whether a meta-analysis could allow us to draw useful conclusions about the risk factors for falls in the elderly. A systematic review was carried out of various databases and completed manually. To satisfy the inclusion criteria, an article had to examine a population of subjects aged over 60 years to pertain to falls occurring during daily living activities, and to involve observational or interventional studies. This review identified 4405 indexed articles published between 1981 and 2011. Of the 220 studies with available data that were included in the final study, just 4% were interventional. Among these 220 studies, just 45% offered a satisfactory level of scientific proof. In total, 88 meta-analyses were carried out on the 156 potential protectors or risk factors that were identified. Our systematic review and meta-analyses ensured that high-quality results were obtained from this comprehensive literature search and included a detailed assessment of the quality of the included studies. Several factors appeared to be disproportionately represented in the literature, a fact that likely reflects the objective and precise assessment of these factors rather than their importance in the falls of the elderly. Thus, we cannot be certain that we obtained the most comprehensive analysis of the risk factors for falling with this method. Meta-analyses can help to define the association between falls and various risk factors, but they have to be used complementary to systematic review for the assessment of risk factors.

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Section: Discussionmentioning

confidence: 99%

Estimation of the risk factors for falls in the elderly: Can meta‐analysis provide a valid answer?

Bloch

Thibaud

Tournoux-Facon

et al. 2012

Geriatrics Gerontology Int

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“…Jadad et al 52 provide some guidance on how to cope with discordant quantitative meta-analyses, but the reader must be in possession of all the discordant reviews, as well as the time and specialized knowledge to decide which methods were most appropriate. We have looked only at reviews in complementary medicine but we suspect that the problem applies also to conventional medicine [3][4][5][6][7] .…”

Section: Discussionmentioning

confidence: 99%

How objective are systematic reviews? Differences between reviews on complementary medicine

Linde¹,

Willich

2003

JRSM

142

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SUMMARYSystematic reviews are considered the most reliable tool to summarize existing evidence. To determine whether reviews that address the same questions can produce different answers we examined systematic reviews of herbal medicine, homeopathy, and acupuncture taken from a previously established database. Information on literature searching, inclusion criteria, selection process, quality assessment, data extraction, methods to summarize primary studies, number of included studies, results and conclusions was compared qualitatively.Seventeen topics (eight on acupuncture, six on herbal medicines, three on homeopathy) had been addressed by 2-5 systematic reviews each. The number of primary studies in the reviews varied greatly within most topics. The most obvious reason for discrepancies between the samples was different inclusion criteria (in thirteen topics). Methods of literature searching may have contributed with some topics but the equivalence of the searches was difficult to assess. Differences were frequently observed in other methodological aspects, in results and in conclusions.This analysis shows that, at least in the three areas examined, systematic reviews often differ considerably. Readers should be aware that apparently minor decisions in the review process can have major impact.

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“…Petticrew and Kennedy invoke Sherlock Holmes to make sense of over 20 systematic reviews that have addressed surgical thromboprophylaxis, many with apparently disparate results (p ) 9. Holmes's bottom line is that surgeons should use mechanical methods rather than heparins, aspirin, or warfarin.…”

Section: Data Excessmentioning

confidence: 99%