State of the Evidence: Current Status and Prospects of Meta-Analysisin Infectious Diseases

Abstract

Meta-analysis is increasingly applied in infectious diseases to summarize clinical data and to evaluate the strength, diversity, and deficiencies of evidence for medical questions of interest. We present an overview of the current status of meta-analysis in the area of infectious diseases and the lessons learnt from its applications. Recently published meta-analyses show that several important areas of research on infectious diseases lack sufficient randomized evidence. Often evidence is scattered across a large number of small trials, making meta-analysis a promising way to integrate diverse results. Quality of trials in the field is often poor. There are several examples where evidence was accumulated primarily for marketing rather than for scientific purposes. Finally, meta-analyses are also raising the problem of what constitutes clinically significant treatment benefits, as well as interesting issues about the reproducibility of clinical evidence and its evolving nature. The increasing applications of meta-analytic methods in the study of infectious diseases may enhance data sharing and international collaborations.

A Meta-Analysis of Studies Comparing the Respiratory Route with the Subcutaneous Route of Measles Vaccine Administration

“…We developed a quality assessment framework (available on request) to facilitate the assessment of the design and the methodology of each study. [7][8][9] Each of the studies was independently assessed as per (1) population description, (2) study design, (3) selection of subjects, (4) mechanism of enrollment, (5) description of vaccine, (6) description of vaccine administration technique.…”

Technical Report: Evidence for the Diagnosis and Treatment of Acute Uncomplicated Sinusitis in Children: A Systematic Overview

“…As part of a previous project, 7,8 we also had retrieved all published randomized, controlled trials on the management of acute uncomplicated sinusitis in all age groups. This collection of randomized, controlled trials had been generated based on Medline searches complemented by Excerpta Medica searches, perusal of the Abstracts for the Interscience Conference on Antimicrobial Agents and Chemotherapy, review of bibliographies of retrieved studies, and communication with technical experts and colleagues in the field.…”

Meta‐Analysis in Medical Research

“…In the right panel of Figure 4, the cumulative meta-analysis is graphically displayed, where data are entered successively, typically in the order of their chronological appearance 46,47 . Such cumulative meta-analysis can retrospectively identify the point in time when a treatment Υear of publication effect first reached conventional levels of significance.…”