Meta-analysis. A quantitative approach to research integration

Thacker, Stephen B.

doi:10.1001/jama.259.11.1685

Cited by 139 publications

(80 citation statements)

References 62 publications

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“…As is noted in this and the previous article (14), several reviews have been published in recent years in which attempts have been made to live up to the mentioned demands (5,27,188,(290)(291)(292)(293)(294)(295)(296). One must hope that development in the direction of more systematic reviews will continue in the years to come .…”

Section: Discussionmentioning

confidence: 75%

Cardiovascular diseases and the work environment. A critical review of the epidemiologic literature on chemical factors.

Kristensen¹

1989

Scand J Work Environ Health

199

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Section: Discussionmentioning

confidence: 75%

Cardiovascular diseases and the work environment. A critical review of the epidemiologic literature on chemical factors.

Kristensen¹

1989

Scand J Work Environ Health

199

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“…The goals of this meta-analysis were to provide precise estimates of patient outcomes and to identify clinical questions concerning revision total knee arthroplasty that are not readily answered by the current literature. Meta-analysis is particularly useful when the extant literature concerning an intervention is composed of numerous small studies that report conflicting results [10,11].…”

Section: Discussionmentioning

confidence: 99%

Patient outcome following revision total knee arthroplasty: a meta-analysis

Sheng

Lehto

Kataja

et al. 2004

International Orthopaedics

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The purpose of this study was to summarize the literature describing patient outcome following revision total knee arthroplasty. Original studies were included if they were published between 1990 and 2002, enrolled ten or more patients, and measured patient outcome using a global knee rating scale. We found 33 studies with a total number of 1,356 patients. There were 429 men and 611 women with a mean age of 67 (45-90) years. The weighted mean follow-up time was 57 (6-108) months. The main indication of revision was loosening. The weighted mean preoperative and postoperative knee scores were 49 (15-82) and 84 (58-109) respectively. There were significant differences between preoperative and postoperative knee and function scores and motion (knee: t=12.507 p<0.001, function: t=4.704 p<0.001, motion: t=5.346 p<0.001). Loosening was also the main complication after revision surgery. In this analysis, revision total knee arthroplasty was a safe and effective procedure.

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“…Although a limitation of RCTs is the general exclusion of information from nonrandomized study designs and qualitative studies, systematic reviews are considered to be the highest level of evidence, 4 providing the most precise estimate of the efficacy of postacute rehabilitation. 5,6 Therefore, this overview of postacute rehabilitation efficacy is grounded primarily in systematic reviews completed in the last 25 years inasmuch as they may be a better guide than individual articles. …”

mentioning

confidence: 99%

Effectiveness of Multidisciplinary Rehabilitation Services in Postacute Care: State-of-the-Science. A Review

Bettger

Stineman

2007

Archives of Physical Medicine and Rehabilitation

141

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Objectives-To summarize the efficacy of postacute rehabilitation and to outline future research strategies for increasing knowledge of its effectiveness.Data Sources-English-language systematic reviews that examined multidisciplinary therapybased rehabilitation services for adults, published in the last 25 years and available through Cochrane, Medline, or CINAHL databases. We excluded multidisciplinary biopsychosocial rehabilitation programs and mental health services.Study Selection-Using the search term rehabilitation, 167 records were identified in the Cochrane database, 1163 meta-analyses and reviews were identified in Medline, and 226 in CINAHL. The Medline and CINAHL search was further refined with 3 additional search terms: therapy, multidisciplinary, and interdisciplinary. In summary, we used 12 reviews to summarize the efficacy of multidisciplinary, therapy-based postacute rehabilitation; the 12 covered only 5 populations.Data Extraction-Two reviewers extracted information about study populations, sample sizes, study designs, the settings and timing of rehabilitation, interventions, and findings.Data Synthesis-Based on systematic reviews, the evidence for efficacy of postacute rehabilitation services across the continuum was strongest for stroke. There was also strong evidence supporting multidisciplinary inpatient rehabilitation for patients with rheumatoid arthritis, moderate to severe acquired brain injury, including traumatic etiologies, and for older adults. Heterogeneity limited our ability to conclude a benefit or a lack of a benefit for rehabilitation in other postacute settings for the other conditions in which systematic reviews had been completed. The efficacy of multidisciplinary rehabilitation services has not been systematically reviewed for many of the diagnostic conditions treated in rehabilitation. We did not complete a summary of findings from individual studies.Conclusions-Given the limitations and paucity of systematic reviews, information from carefully designed nonrandomized studies could be used to complement randomized controlled No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated. The pressure on providers of postacute rehabilitation to deliver clinically effective care will only intensify as cost-containment efforts and requirements for documenting the quality of care increase. Systematically acquired evidence can guide rehabilitation services toward higher quality, effective and cost-efficient care; however, the evidence for certain conditions and rehabilitation settings is better developed than for others. More clearly delineating the evidence of effectiveness will help determine whether certain postacute rehabilitation services produce better outcomes than alternatives. Subsequently, policy-makers, health care administrators, and clinicians might be better informed for making decisions about prov...

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Meta-analysis. A quantitative approach to research integration

Cited by 139 publications

References 62 publications

Cardiovascular diseases and the work environment. A critical review of the epidemiologic literature on chemical factors.

Cardiovascular diseases and the work environment. A critical review of the epidemiologic literature on chemical factors.

Patient outcome following revision total knee arthroplasty: a meta-analysis

Effectiveness of Multidisciplinary Rehabilitation Services in Postacute Care: State-of-the-Science. A Review

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