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Handbook of Epidemiology pp 1377–1411Cite as

Meta-Analysis in Epidemiology

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Abstract

The use of meta-analyses in order to synthesize the evidence from epidemiological studies has become more and more popular recently. It has been estimated by Egger et al. (1998) that from articles retrieved by MEDLINE with the medical subject heading (MeSH) term “meta-analysis” some 33% reported results of a meta-analysis from randomized clinical trials and nearly the same proportion (27%) were from observational studies, including 12% papers in which the etiology of a disease was investigated. The remaining papers include methodological publications or review articles. Reasons for the popularity of meta-analyses are the growing information in the scientific literature and the need of timely decisions for risk assessment or in public health. Methods for meta-analyses in order to summarize or synthesize evidence from randomized controlled clinical trials have been continuously developed during the last years. In 1993, the Cochrane Collaboration was established as an international organization, which provides systematic reviews to evaluate healthcare interventions. They have published a handbook (Higgins and Green 2009) with detailed information on how to conduct systematic reviews of randomized clinical trials. While methods for meta-analyses of randomized clinical trials are now also summarized in several text books, for example, Sutton et al. (2000) and Whitehead (2002), and in a handbook by Egger et al. (2001a) and Dickersin (2002) argued that statistical methods for meta-analyses of epidemiological studies are still behind in comparison to the progress that has been made for randomized clinical trials. The use of meta-analyses for epidemiological research caused many controversial discussions; see, for example, Blettner et al. (1999), Berlin (1995), Greenland (1994), Feinstein (1995), Olkin (1994), Shapiro (1994a,b), or Weed (1997) for a detailed overview of the arguments. The most prominent arguments against meta-analyses are the fundamental issues of confounding, selection bias, as well as the large variety and heterogeneity of study designs and data collection procedures in epidemiological research. Despite these controversies, results from meta-analyses are often cited and used for decisions. They are often seen as the fundamentals for risk assessment. They are also performed to summarize the current state of knowledge often prior to designing new studies.

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    1. Maria Blettner
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    2. Ulrike Krahn
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    3. Peter Schlattmann
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    1. Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany

      Wolfgang Ahrens

    2. Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany

      Iris Pigeot

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    Blettner, M., Krahn, U., Schlattmann, P. (2014). Meta-Analysis in Epidemiology. In: Ahrens, W., Pigeot, I. (eds) Handbook of Epidemiology. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09834-0_21

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