An epidemic of redundant meta‐analyses

荟萃分析 随机对照试验 医学 系统回顾 梅德林 林地 重症监护医学 外科 内科学 政治学 法学
作者
Céline Chapelle,Édouard Ollier,Philippe Girard,Corinne Frère,Patrick Mismetti,Michel Cucherat,Silvy Laporte
出处
期刊:Journal of Thrombosis and Haemostasis [Elsevier BV]
卷期号:19 (5): 1299-1306 被引量:13
标识
DOI:10.1111/jth.15280
摘要

Meta-analyses are widely used to strengthen available evidence and obtain more precise estimates of treatment effect than any individual trial. Paradoxically, multiplication of meta-analyses on the same topic can lead to confusion as practitioners no longer benefit from a rapid and synthetic response. This phenomenon may appear disproportionate when the number of published meta-analyses exceeds the number of original studies.To describe an example of redundant meta-analyses published in the same area with the same randomized clinical trials (RCTs).A systematic review was performed to identify all published meta-analyses of original RCTs that compared direct oral anticoagulants with low molecular weight heparins in cancer patients with venous thromboembolism (VTE). Forest plots were used to represent the meta-analyses results for efficacy (VTE recurrence) and safety (major bleeding) endpoints. An authors' network was constructed to explore the links between the authors of the published meta-analyses.In the past 3 years, four original RCTs were the subject of 20 published meta-analyses by 142 authors: five, four, and 11 meta-analyses pooled the data of two, three, and four RCTs, respectively. The results of meta-analyses were similar regarding the risks of VTE recurrence and major bleeding. The 11 meta-analyses of four RCTs were published within 6 months of the publication of the last RCT.The epidemic proportions of such redundant literature and authorship could be moderated by developing "living" meta-analyses and encouraging authors of new RCTs to update the corresponding meta-analysis in the same paper as their original research.

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