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Meta-analysis: Can We Extract Gold from the Biomedical Literature?

45 Scientific investigation does not march to its conclusions on a straight and open road. Studies may be inconclusive, or even produce conflicting results. They may have defects in design or execution that leave their conclusions open to question. The body of completed studies addressing a particular question may vary considerably in critical aspects such as design, population, measurement, or clinical/experimental protocols, all of which may cloud the interpretation of results and make meaningful comparisons difficult. This process is further complicated by the sheer magnitude of the everexpanding scientific literature. Readers frequently turn to review articles to obtain an overview of the available literature, and to attempt to get a grasp on the level of consensus—and controversy—associated with a particular line of scientific inquiry. Over the last four decades, biomedical research has increasingly turned to the systematic review format to synthesize and provide an overview of the available primary research pertinent to a particular scientific question. Such reviews are associated with careful delineation of a research question, followed by development of a detailed research protocol before commencing the review, including explicit specification of inclusion criteria. Meta-analysis: Can We Extract Gold from the Biomedical Literature?