A new tool to assess Clinical Diversity In Meta‐analyses (CDIM) of interventions

Prophylactic platelet transfusions in hospitalised patients with thrombocytopenia—Protocol for a systematic review with meta‐analysis

“…We expect some clinical heterogeneity among the included trials regarding setting and population. To assess the clinical heterogeneity, we will use the CDIM‐tool 35 and conduct pre‐specified subgroup analyses of trials assessing patients with and without cancer, medical patients, surgical patients and ICU patients.…”

“…Clinical heterogeneity will be assessed using the Clinical Diversity in Meta‐analysis (CDIM) tool 35 and by conducting subgroup analysis (see below).…”

“…If I 2 = 0, we will use and report a fixed-effect model, and if I 2 > 0 we will use both a fixed-and random effects model and report the most conservative estimate (highest P value). 32 Clinical heterogeneity will be assessed using the Clinical Diversity in Meta-analysis (CDIM) tool 35 and by conducting subgroup analysis (see below).…”

Is clinical heterogeneity the foremost prominent threat to the validity of meta‐analyses?

“…Further attempts are made to guide and improve meta-analyses methodology focusing on the clinical diversity challenges as discussed by Joshi and Kehlet in this article. 8 The biased interpretation of results remains a challenge to the external validity of various interventions examined in systematic reviews. The authors Joshi and Kehlet find positive conclusions based on negative results in some of the published systematic reviews and none of the published meta-analyses from systematic reviews on gabapentin had a conclusion aligned with the narrative review by Joshi and Kehlet.…”

“…PRISMA guidelines in the reporting of reviews, 3 PROSPERO for the publication of protocols, 6 and GRADE for the transparency in data quality assessment on outcome level 7 have become tools used to ensure and improve systematic reviews. Further attempts are made to guide and improve meta‐analyses methodology focusing on the clinical diversity challenges as discussed by Joshi and Kehlet in this article 8 …”