Reply to Letter to the Editor: The Sensitivity and Specificity of Ultrasound for the Diagnosis of Carpal Tunnel Syndrome: A Meta-analysis

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We thank Descatha et al. for their interest in our article [3] and their comments. A systematic review and meta-analysis uses a systematic approach to identify evidence from multiple studies to attain an accurate and unbiased estimate of the association between interventions or exposures and events that could be widely applicable to a larger population [4]. By combining patient data from multiple studies appropriately, meta-analyses allow for larger sample sizes and therefore statistical power to determine treatment effects [1, 4]. However, systematic reviews are not without limitations. All reviews are retrospective and observational and therefore are subject to random error and systematic bias [1]. Systematic reviews, when conducted properly, can provide a high level of evidence, improve the precision of the analysis by increasing the sample size, and help to explain differences in study results attributable to heterogeneity [2]. Ultimately, a meta-analysis depends on the quality of the primary studies included in the analysis [2]. We believe that we performed a quality meta-analysis [3], confirmed by high scores on the Oxman and Guyatt index [5], a validated scoring system for the quality of meta-analyses and systematic reviews. …