Meta - Aaiys: Old Bottles But New Wine?

Abstract

Though the concept of meta—analysis was proposed almost two decades ago it is only in the last decade that clinicians are beginning to be hit by the results and implications of this new way of looking at old data. In short, what we are doing is pooling old studies which in themselves were not definitive or had inadequate number& or conflicting results on any aspect of medicine;particul early treatment modalities, and, lo and behold! We have a large, impressive, powerful and statistically significant study which tells us clinicians exactly what to do! While it may sound too good to be true, clinical medicine has been changed rapidly and in a short period by the magic of Meta -Analysis. Are there problerns that clinicians should be aware of? Of course, there are! But, the statisticians have an answer for every one of them sofar! However, not being a very smartperson mysef I am aiwaysput on guard when the ‘geniuses’ of the abstract world tell us working people about these newpanaceasfor all. our problems.

I am in no way suggesting that one should discard meta-analyses. This is a good stop gap measure that guides the physician until more definitive data is forthcoming. However, it should in no way lull the medical community into thinking it has the correct answer and postpone planning appropriate, large, prospective, controlled and tightly run trials to advance our knowledge and evolve, better therapies.

Well,facetiousness aside, I think new knowledge must be allowed fairplay. The world has been used to having old wine delivered to it in new bottles. For a change let us see how well the technique of delivering new wine out. Of old bottles serves us!