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La méta-analyse: évaluation qualitative et quantitative de l’information scientifique en médecine

Meta-analysis, a method for statistical testing of scientific information in medicine

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La méta-analyse est une méthode utilisant des techniques statistiques pour combiner les résultats de plusieurs études différentes, afin d’obtenir une estimation de l’effet global d’un processus étudié. Cette technique offre un gain de puissance, et l’on peut ainsi obtenir une information pertinente que ne peut pas fournir une étude seule. Deux approches sont possibles et souvent intriquées: l’approche quantitative et l’approche qualitative. La méta-analyse offre une plus grande aptitude à généraliser les résultats. Elle diminue la part de subjectivité et oblige à plus de rigueur. Elle aide les médecins, comme les responsables de la politique de santé, à répondre à des questions spécifiques.

Abstract

Meta-analysis is a method which uses statistical techniques for combining results from several different studies, in order to get an estimation of the global effect for a procedure on a global outcome. This technique leads to an increase in the power of statistical testing. It also gives an 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. The different steps of the meta-analysis are described. Meta-analysis shows many advantages, such as the estimation of the effect size or the increase in generalizability. It also helps physicians and health policy makers in answering to a specific question.

References

  1. CANNER PL: An overview of six clinical trials of aspirin in coronary heart disease. Stat Med 1987, 6: 255–263.

    Article  PubMed  CAS  Google Scholar 

  2. COLTON T, FREEDMAN LS, JOHNSON AL, EDS.: Proceedings of the workshop on methodologic issues in overviews of randomized clinical trials. Stat Med 1987, 6: 217–410.

    Article  Google Scholar 

  3. BOISSEL JP, BLANCHARD J, PANAK E, PEYRIEUX JC, SACKS H: Considerations for the meta- analysis of randomized clinical trials. Summary of a panel discussion. Controlled Clin Trials 1989; 10: 254–281.

    Article  PubMed  CAS  Google Scholar 

  4. HENRY DA, WHYTE I. Letter to the editor. N Engl J Med 1988, 318: 186–187.

    Google Scholar 

  5. GERBARG ZB, HOQWITZ RI: Resolving conflicting clinical trials: guidelines for meta- analysis. J Clin Epidemiol 1988, 41: 503–509.

    Article  PubMed  CAS  Google Scholar 

  6. CLEMENS JD, CHUONG JJH, FEINSTEIN AR. The BCG controversy. A methodological and statistical reappraisal. JAMA 1983, 249: 2362–2369.

    Article  PubMed  CAS  Google Scholar 

  7. GIFFORD RH, FEINSTEIN AR. A critique of methodology in studies of anticoagulant therapy for acute myocardial infarction. N Engl J Med 1969, 280: 351–357.

    Article  PubMed  CAS  Google Scholar 

  8. HEWITT P, CHALMERS TC: Using Medline to peruse the literature. Controlled Clin Trials 1985, 6: 75–83.

    Article  PubMed  CAS  Google Scholar 

  9. CHAN SS, SACKS HS, CHALMERS TC: The epidemiology of unpublished randomized control trials. Clin Res 1982, 30: 234A.

    Google Scholar 

  10. DICKERSIN K, CHAN S, CHALMERS TC, SACKS HS, SMITH H JR.: Publication bias and clinical trials. Controlled Clin Trials 1987, 8: 343–353.

    Article  PubMed  CAS  Google Scholar 

  11. GREENWALD AG: Consequences of prejudice against the null hypothesis. Psychol Bull 1975, 82: 1–20.

    Article  Google Scholar 

  12. CHALMERS I, HETHERINGTON J, NEWDICK M.: The Oxford Database of Perinatal Trials: developing a register of published reports of controlled trials. Controlled Clin Trials 1986, 7: 306–324.

    Article  PubMed  CAS  Google Scholar 

  13. The Diabetes Control and Complications Trial Research Group: Are continuing studies of metabolic control and microvascular complications in insulin-dependent diabetes mellitus justified? N Engl J Med 1988, 318: 246–250.

    Google Scholar 

  14. HANSSEN KF, DAHL-JORGENSEN K, LAURITZEN T.: Diabetic control and microvascular complications: the near-normoglycaemic experience. Diabetologia 1986, 29: 677–684.

    Article  PubMed  CAS  Google Scholar 

  15. CONN HO, POYNARD T.: Adrenocorticosteroid administration and peptic ulcer: a critical analysis. J Chronic Dis 1985, 38: 457–468.

    Article  PubMed  CAS  Google Scholar 

  16. MESSER J, REITMAN D, SACKS HS, SMITH H JR, CHALMERS TC.: Association of adrenocorticosteroid therapy and peptic-ulcer disease. N Engl J Med 1983, 309: 21–24.

    PubMed  CAS  Google Scholar 

  17. GELBER RD, GOLDHIRSCH A: The concept of an overview of cancer clinical trials with special emphasis on early breast cancer. J Clin Oncol 1986, 4: 1696–1703.

    PubMed  CAS  Google Scholar 

  18. SACKS HS, BERRIER J, REITMAN D, BERK AA, CHALMERS TC: Meta-analysis of randomized clinical trials. N Engl J Med 1987, 316: 450–455.

    PubMed  CAS  Google Scholar 

  19. YUSUF S, PETO R, LEWIS J, COLLINS R, SLEIGHT P: Beta blockade during and after myocardial infarction: an overview of the randomized trials. Prog Cardiovasc Dis 1985, 27: 335–371.

    Article  PubMed  CAS  Google Scholar 

  20. DEVINE EC, COOK TD: Effects of psychoeducational interventions on length of hospital stay. in Light RJ ed. Evaluation studies. Review annual 1983, 8. Beverly Hills: Sage publications, 1983.

    Google Scholar 

  21. L’ABBÉ KA, DETSKY AS, O’ROURKE K.: Meta-analysis in clinical research. Ann Intern Med 1987, 107: 224–233.

    PubMed  Google Scholar 

Livres sur la méta-analyse

  • A. GLASS GV, MCGAW BM, SMITH ML.: Meta-analysis in social research. Beverly Hills: Sage publications; 1981.

    Google Scholar 

  • B. HEDGES LV, OLKIN I.: Statistical methods for meta-analysis. Orlando: Academic Press; 1985.

    Google Scholar 

  • C. HUNTER JE, SCHMIDT FL, JACKSON GB.: Meta-analysis Cumulating research findings across studies. Beverly Hills: Sage publications; 1982.

    Google Scholar 

  • D. JENICKEK M.: Méta-analyse en médecine. Evaluation et synthèse de l’information clinique et épidémiologique. Paris: Maloine; 1986.

    Google Scholar 

  • E. LIGHT RJ. Evaluation studies. Review annual 1983; 8. Beverly Hills: Sage publications; 1983.

    Google Scholar 

  • F. LIGHT RJ, PILLEMER DB: Summing up. The science of reviewing research. Cambridge: Harvard University Press; 1984.

    Google Scholar 

  • G. ROSENTHAL R.: Meta-analytic procedures for social research. Beverly Hills: Sage publications; 1984.

    Google Scholar 

  • H. WOLF FM: Meta-analysis. Quantitative methods for research synthesis. Beverly Hills: Sage publications; 1986

    Google Scholar 

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Delahaye, F., Landrivon, G. & Ecochard, R. La méta-analyse: évaluation qualitative et quantitative de l’information scientifique en médecine. Androl. 4, 78–88 (1994). https://doi.org/10.1007/BF03034624

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