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Oral A critical appraisal of meta-analysis of randomized controlled trials - a cardiovascular perspective
Farkough, Flather, Yusuf
Introduction: Many meta-analyses have been published in the cardiovascular field over the past decade. There are now examples where the results of meta-analysis combining data from a number of small trials addressing a given clinical problem have been later confirmed (the early fibrinolytic meta-…
Oral An evaluation of large studies and meta-analyses of smaller studies
Cappelleri, Lau, Schmid, Chalmers
Introduction: Several recent large randomized control trials have not supported the effectiveness of treatment found in meta-analyses of smaller trials.
Objective: To compare and evaluate the results of meta-analyses of "smaller" studies with the "largest" study or studies.…
Oral No magic bullets: a systematic overview of 102 trials of interventions to help health care professionals deliver services more effectively or efficiently
Thomson, Oxman, Haynes, Davis, Oxman
Introduction: Patterns of practice often diverge from recommendations based on evidence. There appear to be a number of factors that influence the adoption of research findings into the actual practice of health care providers. A variety of interventions aimed at improving the performance of health…
Oral Failure to conceal treatment allocation schedules in controlled trials influences estimates of treatment effects
Schulz, Chalmers, Hayes, Altman
Introduction: Most reports of randomized controlled trials contain inadequate methodological descriptions.
Objective: To explore the association between inadequate methodological descriptions and estimates of treatment effects.
Methods: We analyzed 250 trials from 33 meta-analyses encompassing 62…
Oral Selecting the language of the publications included in a meta-analysis: is there a Tower of Babel bias?
Gregoire, Derderian, LeLorier
Introduction: Although they usually claim a very thorough search to retrieve every pertinent work, most meta-analyses published in English restrict their search to papers which were also published in English.
Methods: We reviewed all the meta-analyses printed from January 1, 1991 to April 1, 1993…
Oral Database searching in manual medicine
Aker
Introduction: Use of computerized literature databases is expected when background literature searching is conducted. Accessibility, time, and costs make this form of literature retrieval preferable to manual methods. In the field of manual medicine, many relevant journals are not contained in the…
Oral D.I.C.E. therapy: an overview of the randomised trials
Sandercock, Counsell, Slattery, Clarke, Counsell
Introduction: Meta-analyses are increasingly being used to assess the treatment effects. However, care is required in the interpretation of their results.
Objective: To demonstrate how purely chance effects can influence the results of meta-analyses to give results, which could have a major public…
Poster Economic evaluations in the intensive care literature: do they help us solve our financial problems?
Heyland, Kernerman, Cook, Gafni
Objective: To determine the extent to which economic evaluations published in the Intensive Care Unit (ICU) literature provide information that could potentially improve the efficiency of critical care medicine.
Methods: We searched computerized bibliographic databases and manually searched key…
Poster Systematic review of the effectiveness of injury control interventions in children
Klassen, King, Dueck, Oxman
Introduction: Injuries are the leading cause of death in children and adolescents.
Objective: To determine the effectiveness of injury interventions at reducing injuries and reasons for variability between studies.
Methods: Searching electronic databases, writing to authors, reviewing…
Poster Development of a database of studies examining methodologies used in controlled trials and systematic reviews
Cowan, Halpern, Kunz, Oxman, Sackett
Introduction: Many methodological criteria have been established to maximize validity of controlled trials and systematic reviews. Although these criteria are justified on theoretical considerations, many have not been examined empirically, and in a systematic manner, to evaluate whether they…
Poster Trial summary report software and database specifications and preliminary results
Strang, Boissel
Introduction: As the growing number of clinical trials reported each year makes it increasingly difficult to keep up to date, the importance of quantitative overviews correspondingly increases. The quality of a trial overview depends on the quality of the trial summaries on which it is based.…
Poster Clinical trial registries and ethics review boards: the results of a survey by the Fichtre Project
Boissel, Haugh
Introduction: Registration of clinical trials at inception could play an important role in research, by avoiding duplication of trials and serving as a source of information on the existence of clinical trials for those wishing to perform overviews. In order to fulfill their role efficiently those…
Poster The International Collaborative Group on Clinical Trial Registries: aims and achievements
Boissel
The International Collaborative Group on Clinical Trial Registries (ICG-CTRs) held its inaugural meeting in Brussels in 1991. The meeting was sponsored by the European Economic Community. The rationale behind the establishment of the ICG-CTRs was to provide a common interest group with a tool for…
Poster Generalising the results of clinical trials
Glasziou, Irwig
To which groups of patients can we apply the results of clinical trials? Authors and readers often answer this question by reference to the trial entry criteria, that is, the sample frame from which subjects came. As an alternate and more rational answer to the question, we extend a model suggested…
Poster When should an effective treatment be recommended for use? Quantitative derivation of the threshold NNT
Sinclair, Cook, Guyatt, Sackett, Cook, Hayward
Discussion: The number of patients one needs to treat (NNT) to expect to prevent one patient having the adverse target event expresses the effect of an intervention in a clinically compelling way. Absolute risk reduction and its inverse, NNT, varies with baseline risk, and one can conceptualize an…
Poster Interventions to enhance patient adherence to medication prescriptions
Kanani, McKibbon, Haynes
Introduction: Medications cannot be effective if they are not taken by patients. Many patients have difficulty following prescriptions.
Objective: To summarize the results of published studies of interventions to improve adherence with prescribed medications.
Methods: A systematic review of…
Poster A method for allocating evidence in meta-analyses
Goodman
Introduction: Even though meta-analytic methods are often described as a means to combine evidence from multiple studies, standard meta-analytic methods contain no formal measure of this evidence. Most standard methods can be re-interpreted as a sum of log-likelihood curves (Goodman, CCT, 1989),…
Poster An experience of retrieving clinical trials on the drug therapy in acute ischemic stroke using the Japanese medical database
Origasa, Ueki
Introduction: The 3rd International Symposium on Thrombolytic Therapy in Acute Ischemic Stroke was held in Japan on April 1994. Although many clinical trials have been or will be conducted on the theme, there has been no overall assessment. Japanese collaboration is really expected to achieve the…
Poster A method to aggregate results of trials with heterogeneous treatment modalities: a rheumatology example
Boers, Felson, Kessels, Anderson
Introduction: Meta-analysis of antirheumatic therapy has been hampered by the fact that many different drugs have been tested in placebo or head-to-head comparisons, but too few trials are available for any given comparison to perform quantitative analysis with confidence. A previous meta-analysis…
Poster Cost-effectiveness in health care: results of a systematic review
Gray
Introduction: Economic evaluations frequently make use of cost-effectiveness league tables to provide a comparative context for their results. But such league tables may have been criticised as potentially biased or misleading because of their small size, lack of detail, selection criteria, and…