Use of Meta-Analysis to Evaluate Medical Questions of Interest: An Application to Studies of Secondary Prevention of Acute Myocardial Infarction

Abstract

The popularity of meta-analysis in medical research can be attributed to the methodologic appeal of systematically identifying, reviewing, and combining individual studies, and explicitly reporting criteria used in their review. Meta-analysis also increases the chance of detecting effects of moderate size, which nevertheless have important public health implications, through minimization of biases and small random errors. The purpose of this report is to describe how a meta-analysis is performed, including protocol development, literature search strategy, considerations of study homogeneity, and combinability of studies. Methodologic issues concerning the conduct of meta-analysis are also discussed. A meta-analysis performed to evaluate the efficacy of verapamil usage in preventing secondary nonfatal myocardial infarctions among patients recovering from an acute myocardial infarction is presented to illustrate the issues.

Keywords

Meta-analysis Statistical methods Medical intervention

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