Meta-analysis: Its strengths and limitations
REVIEW
■ ABSTRACTNowadays, doctors face an overwhelming amount of information, even in narrow areas of interest. In response, reviews designed to summarize the large volumes of information are frequently published. When a review is done systematically, following certain criteria, and the results are pooled and analyzed quantitatively, it is called a meta-analysis. A well-designed meta-analysis can provide valuable information for researchers, policymakers, and clinicians. However, there are many critical caveats in performing and interpreting them, and thus many ways in which meta-analyses can yield misleading information.
■ KEY POINTSMeta-analysis is an analytical technique designed to summarize the results of multiple studies.By combining studies, a meta-analysis increases the sample size and thus the power to study effects of interest.
In addition to the traditionally known risk factors for outcomes after NCS such as coronary artery disease, diabetes mellitus, chronic renal insufficiency, American Society of Anesthesiology class, the presence of underlying PH can have a significant negative impact on perioperative outcomes.
Aneurysm repair with fenestrated endovascular grafts is associated with a significant risk for adverse renal events (16% in those without renal dysfunction, although none developed a creatinine >2 mg/dL, and 39% for patients with preoperative renal dysfunction). These patients must be meticulously followed, particularly within the first month after such a procedure. When renal artery restenosis is suspected or diagnosed, aggressive approach might be warranted to limit the extent of late renal dysfunction.
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