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Open Access Review

Critical appraisal of meta-analyses: an introductory guide for the practicing surgeon

Nathan Lawrentschuk14, Jonathan McCall24 and Ulrich Güller3*

Author Affiliations

1 Department of Urology, University of Toronto, University Health Network, Toronto, Canada

2 DCRI Communications Group, Duke Clinical Research Institute, Durham, NC, USA

3 European Board Certified Colo-Proctology (EBSQ), Department of Surgery, Division of Visceral Surgery and Transplantation, Inselspital, University of Bern, CH-3010 Bern, Switzerland

4 Department of Surgery, University of Toronto, Toronto, Canada

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Patient Safety in Surgery 2009, 3:16  doi:10.1186/1754-9493-3-16

Published: 22 July 2009

Abstract

Meta-analyses are an essential tool of clinical research. Meta-analyses of individual randomized controlled trials frequently constitute the highest possible level of scientific evidence for a given research question and allow surgeons to rapidly gain a comprehensive understanding of an important clinical issue. Moreover, meta-analyses often serve as cornerstones for evidence-based surgery, treatment guidelines, and knowledge transfer. Given the importance of meta-analyses to the medical (and surgical) knowledge base, it is of cardinal importance that surgeons have a basic grasp of the principles that guide a high-quality meta-analysis, and be able to weigh objectively the advantages and potential pitfalls of this clinical research tool. Unfortunately, surgeons are often ill-prepared to successfully conduct, critically appraise, and correctly interpret meta-analyses. The objective of this educational review is to provide surgeons with a brief introductory overview of the knowledge and skills required for understanding and critically appraising surgical meta-analyses as well as assessing their implications for their own surgical practice.