A Meta-analysis constitutes a systematic review of a specific topic of interest in literary form to provide a quantitative estimation for the outcome of a treatment intervention or exposure. The primary function of a Meta-analysis is to provide standardized approaches for examining existing literature’s possible controversial issue to determine whether a conclusion can be reached on the effect of a treatment (Haidich, 2010). Results that are gotten after a meta-analysis is conducted can refute an opinion or even a widespread belief regarding the effect of an exposure or treatment. One of the features of a well-conducted Meta-analysis lies in the ability to combine the results gotten from the small studies that may have been underpowered to come up with a statistically significant difference in the effect of a particular intervention.
When conducting a Meta-analysis on the incidence of fractured collarbone in children, these are some of the critical information that I have to include in the final analysis.
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The study Question
In the final analysis, the objective for conducting the Meta-analysis and the problem being addressed concerning the incidences of fractured collarbones in children will be included. The goals to be included will consist of both primary and secondary objectives. However, the question of the focus of the Meta-analysis will not have been already answered by the results from the various studies conducted randomly (Russo, 2007). Therefore, the question under the Meta-analysis will be more focused on a particular study group to make it homogenous.
Literature Search
In the final analysis, information as to whether the authors of various studies regarding incidences of fractured collarbone in children had conducted a thorough search for multiple clinical trials in addition to other studies will be included (Haidich, 2010). The studies will also constitute all those that are not yet published and are related to the research question at hand. The final analysis will also include the information sources used in the studies. The literature searches will consist of both computerized and manual searches.
Data Abstraction
Being that this is the most critical step that has to be taken while conducting a meta-analysis, the final analysis will constitute all the methods of data abstraction that were employed by authors in the various studies (Haidich, 2010). Moreover, the standardized data abstraction form that will be developed and utilized by the authors will be indicated in a paper figure. In the final analysis, I will provide readers with enough information that determines whether the studies included in the Meta-analysis are appropriate for a combined report.
Statistical Techniques
Although the statistical methods employed in the studies are not as important as the methods used in determining whether the results gotten from the studies ought to be combined, it is still crucial to be included in the final analysis. This is because, if data across the reviews are not connected as a result of their populations or designs being heterogeneous, the statistical method will be able to correct the mistakes.
Evaluation of the Results
In the final analysis, results from the data abstraction will be presented to allow readers to determine whether the included studies should have been combined. Moreover, a table outlining the features of the reviews, that is, studies design characteristics of subjects, interventions and sample size that may include the duration and dose of any drugs will be included (Russo, 2007). If there exist statistical differences in patient population or study design, it indicates that the existence of heterogeneity thus implying that the data from the studies should not have been combined in the first place.
Assessment of Publication Bias
Since Meta-analyses are prone to publication bias because studies that have negative results are less likely to be published, and some studies may overstate the effect of a particular treatment, information on how such biases were minimized will be included.
Applicability of the Results
Statistically significant results gotten from the Meta-analysis that has utility in clinical practice and comprises messages that researchers plan to use in future studies will also be included in the final analysis. The results will be presented in such a way that they have validity and will impact the care of an individual patient. Moreover, patient populations that are typically seen in clinical practice will also be included in the final analysis.
Even though there often exist problems in providing concrete evidence in treatment effects on incidences of fractured collarbones in children while employing meta-analysis, the one that I conducted has proven to be relevant, valid and appropriate. This is because the pre-specification of the meta-analysis was done following protocols. The analysis specified the objectives of conducting the meta-analysis, the criteria for inclusion and exclusion of the studies that study design, study population, duration and dosage (Haidich, 2010). Moreover, in cases where the meta-analysis included studies that were conducted but their validity not proven, a strategy for identifying the studies was specified. Additionally, the analysis included all the statistical methods that were employed when investigating the heterogeneity of the studies and the approaches that determined the quality of the reviews.
Consequently, the meta-analysis constituted the time at which the protocol for the pooled analysis was specified concerning the performance of the individual studies. More importantly, the report avoided a retrospective specification of the results from all the studies utilized. The protocol for the meta-analysis was specifically indicated during the planning of clinical development programs to manage the incidences of the fractured collarbone (Russo, 2007). The objectives obtained overall estimates of efficacy and further provided a final analysis of the secondary endpoints that were less frequent.
The meta-analysis comprised all the prerequisites of retrospective meta-analyses, that is, the studies that were inconclusive showed positive trends, some were positive, and no statistical or significant numerical heterogeneity existed. Moreover, the analysis comprised of pooled confidence intervals that were well away from zero, a justification of the unlikelihood of the existence of biases in the selection of studies and a sensitivity analysis that demonstrated the robustness of the findings.
Biases in the Meta-Analysis
Some of the prejudices that existed in the meta-analysis that I conducted include;
Publication Bias
In the analysis that I did, there was a notable increase in the number of false positive results. Some of the significant statistical results that had a better chance of being published were published earlier in journal and articles with higher impact factors and were additionally cited by others.
Small-Study Effect
Some of the small studies that I reviewed had systematically different effects from the larger ones. One cause of this was the existence of lower methodological quality of small publication bias. In short, some of the small trials reported more substantial treatment outcomes compared to the more extensive tests.
References
Haidich, A. B. (2010). Meta-analysis in medical research. Hippokratia , 14 (1), 29-37.
Russo, M. W. (2007). How to Review a Meta-analysis. Gastroenterol Hepatol , 3 (8), 637-642.
