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J R Soc Med. 1992 March; 85(3): 165–168.
PMCID: PMC1294821

Meta-analysis of observational epidemiological studies: a review.

Abstract

Meta-analyses (integration of findings by quantitative analyses of results of individual studies) are already widely used in the psychological and educational sciences and in the pooling of clinical trial results. Examples of the application of such techniques to the results of observational epidemiological studies are now proliferating. In this paper meta-analysis of the results of observational epidemiological studies is reviewed. Uncritical adoption of techniques used in pooled analyses of clinical trial results may be inappropriate. Some alternative approaches, including meta-regression techniques, are discussed, and illustrated with reference to examples of meta-analyses of studies of breast cancer risk following oral contraceptive use and of patterns of post-bereavement mortality. Although substantial difficulties beset the use of meta-analysis in epidemiology, many of these problems are also implicit in the execution of traditional, narrative reviews. Foremost among these difficulties are those associated with publication bias and with making due allowance for the quality of the studies being combined. Unlike traditional narrative reviews, meta-analyses require explicit statement of the criteria for the review and hence highlight these difficulties. Nonetheless, careful and critical application of appropriate meta-analytical techniques facilitates quantitative exploration of inhomogeneities in, and (where appropriate) synthesis of study results.

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Selected References

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  • Jones DR. Heart disease mortality following widowhood: some results from the OPCS Longitudinal Study. Office of Population Censuses and Surveys. J Psychosom Res. 1987;31(3):325–333. [PubMed]
  • Parkes CM, Benjamin B, Fitzgerald RG. Broken heart: a statistical study of increased mortality among widowers. Br Med J. 1969 Mar 22;1(5646):740–743. [PMC free article] [PubMed]
  • Rees WD, Lutkins SG. Mortality of bereavement. Br Med J. 1967 Oct 7;4(5570):13–16. [PMC free article] [PubMed]
  • Mellström D, Nilsson A, Odén A, Rundgren A, Svanborg A. Mortality among the widowed in Sweden. Scand J Soc Med. 1982;10(2):33–41. [PubMed]
  • Helsing KJ, Szklo M. Mortality after bereavement. Am J Epidemiol. 1981 Jul;114(1):41–52. [PubMed]
  • Peto R. Why do we need systematic overviews of randomized trials? Stat Med. 1987 Apr-May;6(3):233–244. [PubMed]
  • MANTEL N, HAENSZEL W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959 Apr;22(4):719–748. [PubMed]
  • DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986 Sep;7(3):177–188. [PubMed]
  • Berlin JA, Laird NM, Sacks HS, Chalmers TC. A comparison of statistical methods for combining event rates from clinical trials. Stat Med. 1989 Feb;8(2):141–151. [PubMed]
  • Pocock SJ, Hughes MD. Estimation issues in clinical trials and overviews. Stat Med. 1990 Jun;9(6):657–671. [PubMed]
  • Yusuf S, Peto R, Lewis J, Collins R, Sleight P. Beta blockade during and after myocardial infarction: an overview of the randomized trials. Prog Cardiovasc Dis. 1985 Mar-Apr;27(5):335–371. [PubMed]
  • Meinert CL. Meta-analysis: science or religion? Control Clin Trials. 1989 Dec;10(4 Suppl):257S–263S. [PubMed]
  • Sackett DL. Bias in analytic research. J Chronic Dis. 1979;32(1-2):51–63. [PubMed]
  • Fleiss JL, Gross AJ. Meta-analysis in epidemiology, with special reference to studies of the association between exposure to environmental tobacco smoke and lung cancer: a critique. J Clin Epidemiol. 1991;44(2):127–139. [PubMed]
  • Spitzer WO. Meta-meta-analysis: unanswered questions about aggregating data. J Clin Epidemiol. 1991;44(2):103–107. [PubMed]
  • Gelber RD, Goldhirsch A. Interpretation of results from subset analyses within overviews of randomized clinical trials. Stat Med. 1987 Apr-May;6(3):371–388. [PubMed]
  • Greenland S. Quantitative methods in the review of epidemiologic literature. Epidemiol Rev. 1987;9:1–30. [PubMed]
  • Yach D. Meta-analysis in epidemiology. S Afr Med J. 1990 Jul 21;78(2):94–97. [PubMed]
  • Greenland S, Salvan A. Bias in the one-step method for pooling study results. Stat Med. 1990 Mar;9(3):247–252. [PubMed]
  • Shinton R, Beevers G. Meta-analysis of relation between cigarette smoking and stroke. BMJ. 1989 Mar 25;298(6676):789–794. [PMC free article] [PubMed]
  • Wong O, Raabe GK. Critical review of cancer epidemiology in petroleum industry employees, with a quantitative meta-analysis by cancer site. Am J Ind Med. 1989;15(3):283–310. [PubMed]
  • Longnecker MP, Berlin JA, Orza MJ, Chalmers TC. A meta-analysis of alcohol consumption in relation to risk of breast cancer. JAMA. 1988 Aug 5;260(5):652–656. [PubMed]
  • Berlin JA, Colditz GA. A meta-analysis of physical activity in the prevention of coronary heart disease. Am J Epidemiol. 1990 Oct;132(4):612–628. [PubMed]
  • Romieu I, Hernandez-Avila M, Liang MH. Oral contraceptives and the risk of rheumatoid arthritis: a meta-analysis of a conflicting literature. Br J Rheumatol. 1989;28 (Suppl 1):13–23. [PubMed]
  • Goldsmith JR, Beeser S. Strategies for pooling data in occupational epidemiological studies. Ann Acad Med Singapore. 1984 Apr;13(2 Suppl):297–307. [PubMed]
  • Spector TD, Thompson SG. The potential and limitations of meta-analysis. J Epidemiol Community Health. 1991 Jun;45(2):89–92. [PMC free article] [PubMed]
  • Furberg CD, Morgan TM. Lessons from overviews of cardiovascular trials. Stat Med. 1987 Apr-May;6(3):295–306. [PubMed]
  • Jenicek M. Meta-analysis in medicine. Where we are and where we want to go. J Clin Epidemiol. 1989;42(1):35–44. [PubMed]
  • Chalmers I. Underreporting research is scientific misconduct. JAMA. 1990 Mar 9;263(10):1405–1408. [PubMed]
  • Simes RJ. Publication bias: the case for an international registry of clinical trials. J Clin Oncol. 1986 Oct;4(10):1529–1541. [PubMed]
  • Lichtenstein MJ, Mulrow CD, Elwood PC. Guidelines for reading case-control studies. J Chronic Dis. 1987;40(9):893–903. [PubMed]
  • Oxman AD, Guyatt GH, Singer J, Goldsmith CH, Hutchison BG, Milner RA, Streiner DL. Agreement among reviewers of review articles. J Clin Epidemiol. 1991;44(1):91–98. [PubMed]

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