Top Things to Know: Methodological Standards for Meta-Analyses and Qualitative Systematic Reviews of Cardiac Prevention and Treatment Studies
Published: August 07, 2017
- More than 10,000 meta-analyses and qualitative systematic reviews are published annually, roughly double the number published annually just five years ago.
- A PubMed search for the terms “meta-analysis” and “cardiovascular” resulted in 53 publications for the year 2000, 413 for 2010, and more than 1100 publications in 2014.
- This AHA statement serves different purposes for different audiences:
- Researchers: provide guidance to researchers who wish to carry out meta-analyses, especially in the fields of cardiovascular disease prevention and treatment
- Readers: inform users and consumers of meta-analyses who wish to assess methodological quality and not just the completeness of reporting
- Editors: Journal editors are a key audience since they must decide whether to publish a particular meta-analysis.
- In addition to encouraging potential authors to consider their research question and whether there is a need to answer the question with a meta-analysis, potential authors are encouraged to register their protocol.
- The methods used in 82 recent high-quality meta-analyses in cardiovascular sciences were surveyed for this scientific statement.
- The Statement systematically addresses nine important questions:
- What are effective methods for searching for studies to include in a meta-analysis?
- How should studies be selected for inclusion?
- What are acceptable methods for data extraction and standardization from individual studies?
- How should quality of individual studies be assessed?
- How should heterogeneity be quantified and handled?
- What are acceptable methods for pooling results across studies and how do these methods vary according to study design and the frequency of outcomes?
- What are acceptable methods for identifying publication bias?
- What are acceptable methods and guiding principles for carrying out sensitivity and subgroup analyses?
- What are emerging meta-analytical methods for studies addressing cardiovascular prevention and treatments?
- Examples of Forest Plots, Meta-Regression; and Funnel Plots guide readers in assessing heterogeneity and publication bias.
- The Evidence-Based Medicine (EBM) movement promotes a systematic approach to assessing quality of evidence, research design, and other characteristics of individual publications. High-quality meta-analyses can inform EBM approaches.
Citation
Rao G, Lopez-Jimenez F, Boyd J, D’Amico F, Durant NH, Hlatky MA, Howard G, Kirley K, Masi C, Powell-Wiley TM, Solomonides AE, West CP, Wessel J; on behalf of the American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Surgery and Anesthesia; Council on Clinical Cardiology; Council on Genomic and Precision Medicine; and Stroke Council. Methodological standards for meta-analyses and qualitative systematic reviews of cardiac prevention and treatment studies: a scientific statement from the American Heart Association [published online ahead of print August 7, 2017]. Circulation. doi: 10.1161/CIR.0000000000000523.