Editorial
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World J Meta-Anal. May 26, 2013; 1(1): 5-7
Published online May 26, 2013. doi: 10.13105/wjma.v1.i1.5
Meta-analyses in the wonderland of neurology
Francesco Brigo, Stanley Chidi Igwe
Francesco Brigo, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Section of Clinical Neurology, University of Verona, 10, 37134 Verona, Italy
Stanley Chidi Igwe, Department of Neuro-Psychiatry, Federal Teaching Hospital, P.M.B 102, Abakaliki, 480001, Ebonyi State, Nigeria
Author contributions: Brigo F designed and wrote the paper; Igwe SC was greatly involved in editing the manuscript.
Correspondence to: Francesco Brigo, MD, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Section of Clinical Neurology, University of Verona, Piazzale L.A. Scuro, 10, 37134 Verona, Italy. dr.francescobrigo@gmail.com
Telephone: +39-45-8124174 Fax: +39-45-8124873
Received: February 19, 2013
Revised: April 3, 2013
Accepted: April 9, 2013
Published online: May 26, 2013
Processing time: 93 Days and 17.5 Hours
Abstract

Meta-analyses are often misused and underused in neurology. This editorial provides some comments on the role of meta-analyses in neurological research. Recently, a huge increase in the number of meta-analyses and systematic reviews has been observed in neurological journals. The major strengths of meta-analyses are the increase of statistical power. However, as for any other investigative tool, meta-analytic research is a research method itself which can produce severe shortcomings. Specifically, the issues of search terms, time periods of published studies, databases used for searching, the definitions of inclusion and exclusion criteria for papers (which greatly affect clinical heterogeneity), publication bias; and the statistical methods used, dramatically influence the results of meta-analyses. The main problem of meta-analyses is that they cannot be expected to overcome the limitations of the studies they include (the so-called “garbage in, garbage out” phenomenon). Furthermore, most systematic reviews in the neurological literature lead to the unsatisfying and clinically frustrating statement “further studies are needed”. However it is much more frustrating to see how the gaps in scientific knowledge identified by meta-analyses have not been translated into serious efforts to fill them. Besides their role in evaluating efficacy and tolerability of drugs, meta-analyses may be used to assess diagnostic values of debatable clinical findings, as they represent powerful tools to try to answer questions not posed by individual studies and to settle controversies arising from conflicting claims.

Keywords: Clinical evaluation; Epilepsy; Meta-analysis; Migraine; Neurology

Core tip: Besides their role in evaluating efficacy and tolerability of drugs, meta-analyses may be used to assess diagnostic values of debatable clinical findings, as they represent powerful tools to try to answer questions not posed by individual studies and to settle controversies arising from conflicting claims.