Search PubMedSearch

PubMed · 10115991

Meta-analysis.

Abstract

Meta-analysis corresponds to all systematic methods which use statistical techniques for combining results from several independent studies. The aim is to get a consistent estimation of the global effect of a procedure on a specified outcome. The technique allows us to increase the power of statistical testing, and to get information which cannot be drawn from one individual study. Two approaches are possible, and often combined: the qualitative approach consists of weighing various studies according to their methodological quality; the quantitative approach consists of pooling the results of different studies, in order to generate results with a higher statistical power. A meta-analysis is a long and rigorous process, which follows several steps: statement of objectives; definition of articles inclusion and exclusion criteria; literature search; collection of data and evaluation of the quality of each study; tests for homogeneity; pooling; sensitivity analyses; presentation of results; and conclusions. Meta-analysis has several advantages: it estimates the size of an effect; it improves the generalizability; it compels to rigor; it lessens the part of subjectivity. When meta-analysis is cautiously and properly done, it brings new useful information, and helps physicians and health policy makers in answering to a specific question.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

F Delahaye, G Landrivon, R Ecochard, C Colin. 1991. Meta-analysis.. https://doi.org/10.1016/0168-8510(91)90007-k

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Changes in the scope of care provided by primary care physicians.

BACKGROUND: Strategies to control medical costs and improve the quality of care often translate into decisions affecting the range of services primary care physicians provide to patients, which patients are referred for specialty care, and the points in disease processes at which referrals are made. This study focused on physicians' assessments of changes in the scope of care provided by primary care physicians and their assessments of the appropriateness of the scope of the care that primary care physicians are expected to provide. METHODS: We analyzed data from the 1996-1997 Community Tracking Study Physician Survey. Telephone interviews were conducted with 12,385 physicians (reflecting a response rate of 65 percent) who were drawn from a representative random sample of physicians providing direct patient care in the continental United States and not employed by the federal government. The analysis was based on responses from the 7015 primary care physicians and 5092 specialists who had been in practice for at least two years. RESULTS: Thirty percent of the primary care physicians and 50 percent of the specialists reported that the scope of care provided by primary care physicians had increased during the previous two years. Twenty-four percent of the primary care physicians and 38 percent of the specialists reported that the scope of care expected to be provided by primary care physicians was greater than it should be. According to multivariate analysis, primary care physicians other than general or family practitioners (i.e., pediatricians and general internists), those who were in one- or two-physician practices, those who received revenues from capitation, and those who served as gatekeepers for their patients' care were significantly more likely to report that the scope of care they were expected to provide was greater than it should be. CONCLUSIONS: The finding that nearly one in four primary care physicians reported that the scope of care they were expected to provide was greater than it should be arouses concern about the potential impact of changes in the delivery of health care. The associations we found between financial and administrative aspects of managed care and physicians' concern about the scope of care they provide to their patients deserve careful consideration.

Data Collection

The quest for better questionnaires.

The development of questionnaires is a neglected enterprise in epidemiology. It has recently been proposed that a prestigious health authority such as the World Health Organization establish a committee to tackle issues of questionnaire quality, moving eventually toward standardized instruments. However, standardization may not be the best way to invigorate this enterprise. As an alternative, the author suggests that the first step in improving questionnaires would be to make them more accessible. Ideally, questionnaires should be as easily scrutinized as a study's methods or results. To this end, the author suggests that when a research paper is published, the entire questionnaire be made available on the worldwide web. Electronic access to questionnaires could stimulate a new era of awareness about the importance of questionnaire design.

Data Collection