Meta-analysis as a manifestation of ‘bondförnuft’ (‘peasant sense’)

The meta‐analytic big bang

“…A good illustration is Stjernswärd's (, ) quantitative synthesis, often cited as an early example of meta‐analysis in medicine. Stjernswärd's question was whether postoperative radiation therapy in early breast cancer patients increased mortality.…”

Commentary for history special issue of Research Synthesis Methods

“…In 1974, a Swedish radiotherapist combined estimates from five similar randomized trials and showed that radiotherapy after surgery increased mortality in women with breast cancer (Stjernswärd, ). When I asked him what had led him to use statistical synthesis, he thought for a moment then said it was simply ‘bondförnuft’ – ‘peasant sense’ (Stjernswärd, ). Others working in heart disease, cancer, and perinatal care had arrived at similar conclusions (Chalmers et al, ; Peto et al, ; Chalmers, ).…”

Treatments to die for

“…seemed to be associated with increased mortality, an iatrogenic failure'. 5 However, complementary medicine, including acupuncture, can sometimes ameliorate such problems.…”

“…Radiotherapy to the breast is one example where many women have had progressive problems resulting in, for instance, bone necrosis and soft tissue fibrosis, leading in some cases to bone fractures, arm amputations, and second cancers 4 . Indeed, according to Jan Stjernswärd, ‘routine use of radiotherapy in early breast cancer … seemed to be associated with increased mortality, an iatrogenic failure’ 5 . However, complementary medicine, including acupuncture, can sometimes ameliorate such problems.…”