| Ref ID | 134 |
| First Author | G. Imberger |
| Journal | BMJ OPEN |
| Year Of Publishing | 2016 |
| URL | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4985805/pdf/bmjopen-2016-011890.pdf |
| Keywords |
• Cochrane • Statistical • Power • General medical |
| Problem(s) |
• Perpetuates citation of poor quality primary study data • Small number of trials in meta-analyses |
| Article Type | Empirical |
| Article Subtype | Cross-sectional survey/Methodological systematic review |
| First Author Country | Denmark |
| Aim | To explore the role of trial sequential analysis in assessing the reliability of conclusions by screening the Cochrane Database of Systematic reviews to select 100 meta-analyses published between 2010 and 2013 with a binary outcome, a negative result and sufficient power. |
| Level of Investigation | Analytical |
| Summary of Findings | Using conventional cumulative meta-analysis, false positives were present in seven of the 100 included meta-analyses (7%, 95% CI 3% to 14%), occurring more than once in three. The total number of false positives was 14 and trial sequential analysis prevented 13 of these (93%, 95% CI 68% to 98%). In a post hoc analysis, the authors found that Cochrane meta-analyses that are negative are 1.67 times more likely to be updated (95% CI 0.92 to 2.68) than those that are positive. |
| Number of systematic reviews included | 100 |
| Number of eligible systematic reviews assessed | 4736 |
| Treatment impacted | Yes |
| Treatment impacted description | The authors reconducted the meta-analyses, using conventional cumulative techniques, to measure how many false positives would have occurred if the meta-analyses had been updated after each new trial. For each false positive, they performed trial sequential analysis, using three different approaches. |
| Interpretation impacted | Yes |
| Interpretation impacted description | The authors found false positives in 7% (95% CI 3% to 14%) of the included reviews using conventional cumulative meta-analyses. |