Systematic reviews as a tool for planning and\ud interpreting trials

Article English OPEN
Bath, Philip M.W. ; Gray, Laura J. (2009)

Background Systematic reviews followed by ameta-analysis\ud are carried out in medical research to combine the results of two or more related studies. Stroke trials have struggled to show beneficial effects and meta-analysis should be used more widely throughout the research process to either speed up the development of useful interventions, or halt more quickly research with hazardous or ineffective interventions.\ud \ud Summary of review. This review summarises the clinical research process and illustrates how and when systematic\ud reviews may be used throughout the development programme.\ud Meta-analyses should be performed after observational\ud studies, preclinical studies in experimental stroke, and\ud after phase I, II, and III clinical trials and phase IV clinical surveillance studies. Although meta-analyses most commonly work with summary data, they may be performed to assess relationships between variables (meta-regression) and, ideally, should utilise individual patient data. Meta-analysis techniques may alsoworkwith ordered categorical outcome data (ordinal meta-analysis) and be used to perform indirect comparisons where original trial data do not exist.\ud \ud Conclusion Systematic review/meta-analyses are powerful\ud tools in medical research and should be used throughout\ud the development of all stroke and other interventions
  • References (38)
    38 references, page 1 of 4

    1. Wardlaw JM, Zoppo G, Yamaguchi T, Berge E. Thrombolysis for acute ischaemic stroke. Cochrane Database Systematic Review 2003(3).

    2. The ATLANTIS ECASS and NINDS rt-PA Study Group Investigators. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. The Lancet 2004;363:768-813.

    3. Gubitz G, Sandercock P, Counsell C. Antiplatelet therapy for acute ischaemic stroke. Cochrane Database of Systematic Reviews 2003(2).

    4. Stroke Unit Trialists' Collaboration. Organised inpatient (stroke unit) care for stroke. Cochrane Database of Systematic Reviews 2002.

    5. Vahedi K, Hofimeijer J, Vacaut E, et al. Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials. Lancet Neurology 2007;6:215-22.

    6. Lees KR, Muir KW. Excitatory amino acid antagonists for acute stroke (Cochrane Review). The Cochrane Library. In press ed. Oxford: Update Software, 2002.

    7. Gubitz G, Counsell C, Sandercock P. Anticoagulants for acute ischaemic stroke. Cochrane Database of Systematic Reviews 2004(3).

    8. Willmot M, Leonardi-Bee J, Bath PM. High blood pressure in acute stroke and subsequent outcome: a systematic review. Hypertension 2004;43(1):18-24.

    9. Sandercock P, Roberts I. Systematic reviews of animal experiments. The Lancet 2002;360:586.

    10. Stroke Therapy Academic Industry Roundtable (STAIR). Recommendations for standards regarding preclinical neuroprotective and restorative drug development. Stroke 1999;30:2752- 2758.

  • Metrics
    No metrics available
Share - Bookmark