Is meta-analysis the "top of the evidence pyramid" in cardiology?
https://doi.org/10.15829/1728-8800-2024-3925
EDN: NNCAAC
Abstract
The author comments on the significance and place of meta-analyses in modern evidence-based medicine, primarily in cardiology. The history of meta-analyses is briefly described. The main limitations of meta-analyses are reviewed. Examples are given where meta-analyses on the same problem had directly opposite results. The importance of meta-analyses in identifying side effects of drugs is discussed. The possibility of manipulating the results of meta-analyses is demonstrated. The significance of meta-analyses is currently being assessed through the example of the coronavirus pandemic, when different meta-analyses assessed the effectiveness and safety of the same drugs differently.
The author concludes that meta-analyses should be excluded from level I evidence and given a more modest role in the hierarchy of evidence.
About the Author
S. Yu. Martsevich
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
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Supplementary files
What is already known about the subject?
- Meta-analyses are traditionally considered to be at the highest level of evidence hierarchy.
What might this study add?
- Meta-analysis as a top of evidence questioned because it is a type of retrospective, non-randomized study. Different meta-analyses on the same problem often give opposite results, and the meta-analysis procedure itself makes it possible to manipulate results.
Review
For citations:
Martsevich S.Yu. Is meta-analysis the "top of the evidence pyramid" in cardiology? Cardiovascular Therapy and Prevention. 2024;23(1):3925. (In Russ.) https://doi.org/10.15829/1728-8800-2024-3925. EDN: NNCAAC
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