Journal of Clinical Epidemiology
Volume 49, Issue 2 , Pages 235-243, February 1996

Meta-analyses to evaluate analgesic interventions: A systematic qualitative review of their methodology

  • Alejandro R. Jadad

      Affiliations

    • Oxford Regional Pain Relief Unit, Churchill Hospital, University of Oxford, Oxford, United Kingdom
    • Nuffield Department of Anaesthetics, University of Oxford, Oxford, United Kingdom
    • Current address: Department of Clinical Epidemiology and Biostatistics, McMaster University, 1200 Main Street West, Hamilton, Canada L8N 325.
    • ,
  • Henry J. McQuay

      Affiliations

    • Corresponding Author InformationPlease address correspondence to: Henry J. McQuay, Oxford Regional Pain Relief Unit, Churchill Hospital, Oxford, OX3 7LJ, United Kingdom.
    • Oxford Regional Pain Relief Unit, Churchill Hospital, University of Oxford, Oxford, United Kingdom
    • Nuffield Department of Anaesthetics, University of Oxford, Oxford, United Kingdom

Received in revised form 11 October 1994

Abstract 

A systematic search of the literature was performed to identify the maximum possible number of meta-analyses that evaluated analgesic interventions. Seventy-four reports were identified and retrieved and the scientific quality of 80 separate meta-analyses was assessed under blind conditions by 2 judges using Oxman and Guyatt's index. Most of the meta-analyses evaluated pharmacological interventions for chronic pain conditions and two-thirds were published since 1990. Ninety percent of the meta-analyses had methodological flaws that could limit their validity. The main deficiencies were lack of information on methods to retrieve and to assess the validity of primary studies and lack of data on the design of the primary studies. Meta-analyses of low quality produced significantly more positive conclusions.

For several topics, different meta-analyses evaluating the same intervention produced conflicting results. The need to resolve these contradictions is highlighted.

Keywords:  Meta-analysis, review literature, methodology research, bias, pain analgesia, indexing, abstracting

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PII: 0895-4356(95)00062-3

Journal of Clinical Epidemiology
Volume 49, Issue 2 , Pages 235-243, February 1996

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