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Title: Evidence synthesis as the key to more coherent and efficient research.
Authors: Sutton, Alexander J.
Cooper, Nicola J.
Jones, David R.
First Published: 30-Apr-2009
Publisher: BioMed Central Ltd
Citation: BMC Medical Research Methodology, 2009, 9 : 29
Abstract: Background: Systematic review and meta-analysis currently underpin much of evidence-based medicine. Such methodologies bring order to previous research, but future research planning remains relatively incoherent and inefficient. Methods: To outline a framework for evaluation of health interventions, aimed at increasing coherence and efficiency through i) making better use of information contained within the existing evidence-base when designing future studies; and ii) maximising the information available and thus potentially reducing the need for future studies. Results: The framework presented insists that an up-to-date meta-analysis of existing randomised controlled trials (RCTs) should always be considered before future trials are conducted. Such a meta-analysis should inform critical design issues such as sample size determination. The contexts in which the use of individual patient data meta-analysis and mixed treatment comparisons modelling may be beneficial before further RCTs are conducted are considered. Consideration should also be given to how any newly planned RCTs would contribute to the totality of evidence through its incorporation into an updated meta-analysis. We illustrate how new RCTs can have very low power to change inferences of an existing meta-analysis, particularly when between study heterogeneity is taken into consideration. Conclusion: While the collation of existing evidence as the basis for clinical practice is now routine, a more coherent and efficient approach to planning future RCTs to strengthen the evidence base needs to be developed. The framework presented is a proposal for how this situation can be improved.
DOI Link: 10.1186/1471-2288-9-29
eISSN: 1471-2288
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © 2009 Sutton et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Appears in Collections:Published Articles, Dept. of Health Sciences

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