Perils of meta-analysis

In a recent issue of the Archives, Batra et al presented a systematic review and meta-analysis comparing two strategies for weaning neonates from positive pressure mechanical ventilation: synchronised intermittent mandatory ventilation (SIMV) and pressure support ventilation (PSV).1 With the former, some breaths are assisted and others are not, but with the latter, all breaths are synchronised with some positive pressure assistance. Analyses like this are valuable, as choices of ventilation strategies in our nurseries are typically based on personal preferences rather than carefully developed evidence. The small sizes of the trials identified for this meta-analysis demonstrate the difficulty of enrolling sufficient numbers of subjects to produce useful information. When such evidence is available, it must be assessed with careful attention to detail, particularly when it suggests that one approach or another may lead to superior outcomes. The analysis by Batra et al exemplifies some of the pitfalls...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - Category: Perinatology & Neonatology Authors: Tags: Editorials Source Type: research