Methodological issues in meta-analyses of observational studies: the need for attention to the details

Ref ID 814
First Author E.M.H. Padrao
Journal BRITISH JOURNAL OF ANAESTHESIA
Year Of Publishing 2022
URL https://www.bjanaesthesia.org/article/S0007-0912(22)00064-2/fulltext
Keywords • COVID
• Error
• Statistical
• Observational studies
• Outcomes
• Non-Cochrane reviews
Problem(s) • Errors in effect estimate calculations or data synthesis
• Failure to define clinically meaningful outcomes
• Inclusion of observational / non-randomised studies
Article Type Editorial
Article Subtype Comment/letter
First Author Country United States
Aim A letter highlighting concerns with the conduct of one systematic review and meta-analysis of prone positioning in non-intubated spontaneously breathing patients in patients with COVID-19 published in 2022.
Level of Investigation Analytical
Summary of Findings The authors of the letter highlight concerns with the conduct of one systematic review and meta-analysis of prone positioning in non-intubated spontaneously breathing patients in patients with COVID-19 published in 2022. These include the questionable choice of outcome and outcome measurement used in the systematic review and the use of unadjusted results from observational studies in the pooled analysis. The letter authors perform an adjusted analysis of the systematic review using only studies which adjusted for confounding which the letter authors argue leads to a more precise estimate of efficacy than the original review.
Number of systematic reviews included 1
Number of eligible systematic reviews assessed 1
Treatment impacted Yes
Treatment impacted description The letter authors perform an adjusted analysis of the systematic review using only studies which adjusted for confounding which the letter authors argue leads to a different estimate of efficacy than the original review.
Interpretation impacted No
Interpretation impacted description