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J Natl Med Assoc. Jul 1997; 89(7): 477–485.
PMCID: PMC2568083
The application of meta-analysis in assessing racial differences in the effects of antihypertensive medication.
P. Messeri, S. Workman, C. Saunders, and C. Francis
Urban Health Institute, Harlem Hospital Center, New York, New York, USA.
Meta-analysis is an important technique for synthesizing research findings. Although the statistical foundations of meta-analysis continue to be debated, few question its value as a rigorous framework for organizing literature reviews. In recent years, there has been increasing emphasis on the use of meta-analysis not only to summarize the central tendency of findings but also to explain variation between studies. This article reviews the major steps in a meta-analysis with an emphasis on comparative analysis of subgroups of studies. A meta-analysis of the antihypertensive efficacy of calcium channel blockers is used to illustrate how a comparative analysis can be applied to investigate racial variation in the effects of calcium channel blockers. A statistically significant trend is found between the proportion of African-American hypertensive subjects and the mean reduction in blood pressure. Meta-analytic techniques also are applied to explore possible confounders due to differences in research design and patient characteristics.
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