On October 20 began the III Refresher Course on Spine Pathology. I have had the honor of participating as a guest speaker on one of the hot topics in research, meta-analyses. We often base our decisions on personal experience. But do we really offer the best evidence? Learning how to provide the highest level of high quality evidence in a short time is crucial to making the best decision. «Meta-analysis refers to the statistical analysis of a large collection of results from individual studies for the purpose of integrating the findings.» The number of meta-analyses is increasing and is the most important tool in medical practice.
Given the amount of information and novel products in spine surgery, systematic reviews and meta-analyses have become indispensable methods for the evaluation of medical interventions.
The advent of evidence-based practice (EBP) in the early 1990s, it quickly became apparent that synthesized summaries of «all» the evidence within a particular setting, in addition to the evidence from primary studies, would be needed for clinicians to make truly informed decisions. Clinical trials are often small and underpowered to detect treatment benefit.
However, there is heated debate about the value of systematic reviews. Many believe that they represent the highest level of evidence on which to base treatment recommendations. Although there is still some controversy, most agree that the scientific quality of a review is closely linked to the reduction of the biases inherent in this form of research. Publication bias can occur when non-significant studies are not published or when the authors of the systematic review do not perform a literature search. Selection bias occurs when the selection of studies for inclusion in the review is influenced by factors such as the results, the authors, or some other factor.
Systematic reviews have also been criticized for pooling data from a heterogeneous sample of studies (with different numbers of cases, disease severity or comorbidities). Although, this type of research is necessary to help clinicians continually provide evidence-based medicine. based on evidence.