<i>Annals</i> Understanding Clinical Research: Evaluating the Meaning of a Summary Estimate in a Meta-analysis

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Special Articles15 August 2017Annals Understanding Clinical Research: Evaluating the Meaning of a Summary Estimate in a Meta-analysisJohn E. Cornell, PhD, Joshua M. Liao, MD, MSc, Catharine B. Stack, PhD, MS, and Cynthia D. Mulrow, MD, MScJohn E. Cornell, PhDFrom University of Texas Health Science Center, San Antonio, Texas, and University of Pennsylvania and American College of Physicians, Philadelphia, Pennsylvania.Search for more papers by this author, Joshua M. Liao, MD, MScFrom University of Texas Health Science Center, San Antonio, Texas, and University of Pennsylvania and American College of Physicians, Philadelphia, Pennsylvania.Search for more papers by this author, Catharine B. Stack, PhD, MSFrom University of Texas Health Science Center, San Antonio, Texas, and University of Pennsylvania and American College of Physicians, Philadelphia, Pennsylvania.Search for more papers by this author, and Cynthia D. Mulrow, MD, MScFrom University of Texas Health Science Center, San Antonio, Texas, and University of Pennsylvania and American College of Physicians, Philadelphia, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-1454 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In traditional meta-analyses, researchers combine data from individual studies into a summary measure to describe the benefits or harms of an intervention. The pooled estimate is calculated by first estimating the treatment effect and 95% CI for each individual study. Each study's estimated treatment effect is then weighted, usually by its precision, to reflect the amount of information the study contains relative to the others. The pooled overall treatment effect is the weighted average of the individual treatment effect estimates.This installment of the “Understanding Clinical Research” series addresses issues (Table) that readers should consider when evaluating the meaning of ...References1. Gargiulo G, Sannino A, Capodanno D, Barbanti M, Buccheri S, Perrino C, et al. Transcatheter aortic valve implantation versus surgical aortic valve replacement: a systematic review and meta-analysis. Ann Intern Med. 2016;165:334-44. [PMID: 27272666]. doi:10.7326/M16-0060 LinkGoogle Scholar2. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557-60. [PMID: 12958120] CrossrefMedlineGoogle Scholar3. Leon MB, Smith CR, Mack MJ, Makkar RR, Svensson LG, Kodali SK, et al; PARTNER 2 Investigators.. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2016;374:1609-20. [PMID: 27040324] doi:10.1056/NEJMoa1514616 CrossrefMedlineGoogle Scholar4. Thourani VH, Kodali S, Makkar RR, Herrmann HC, Williams M, Babaliaros V, et al. Transcatheter aortic valve replacement versus surgical valve replacement in intermediate-risk patients: a propensity score analysis. Lancet. 2016;387:2218-25. [PMID: 27053442] doi:10.1016/S0140-6736(16)30073-3 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Texas Health Science Center, San Antonio, Texas, and University of Pennsylvania and American College of Physicians, Philadelphia, Pennsylvania.Acknowledgment: The authors thank the senior clinical and statistical editors from Annals of Internal Medicine for their input and review of earlier drafts of the manuscript.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-1454.Corresponding Author: John E. Cornell, PhD, University of Texas Health Science Center at San Antonio, 7703 Merton Minter Boulevard, San Antonio, TX 78299; e-mail, [email protected]edu.Current Author Addresses: Dr. Cornell: University of Texas Health Science Center at San Antonio, 7703 Merton Minter Boulevard, San Antonio, TX 78299.Dr. Liao: Department of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104.Dr. Stack: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.Dr. Mulrow: University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229.Author Contributions: Conception and design: J.E. Cornell, J.M. Liao, C.B. Stack, C.D. Mulrow.Analysis and interpretation of the data: J.E. Cornell, J.M. Liao.Drafting of the article: J.E. Cornell, J.M. Liao, C.B. Stack, C.D. Mulrow.Critical revision of the article for important intellectual content: J.E. Cornell, J.M. Liao, C.B. Stack, C.D. Mulrow.Final approval of the article: J.E. Cornell, J.M. Liao, C.B. Stack, C.D. Mulrow.Statistical expertise: J.E. Cornell.Collection and assembly of data: J.E. Cornell.This article was published at Annals.org on 8 August 2017. 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