Scientific hypotheses can be tested by comparing the effects of one treatment over many diseases in a systematic review

Yen-fu Chen, Karla Hemming, Peter J. Chilton, Keshav K. Gupta, Douglas G. Altman, Richard J. Lilford

    Research output: Contribution to journalArticlepeer-review

    17 Citations (Scopus)
    127 Downloads (Pure)

    Abstract

    Objectives
    To describe the use of systematic reviews or overviews (systematic reviews of systematic reviews) to synthesize quantitative evidence of intervention effects across multiple indications (multiple-indication reviews) and to highlight issues pertaining to such reviews.

    Study Design and Setting
    MEDLINE was searched from 2003 to January 2014. We selected multiple-indication reviews of interventions of allopathic medicine that included evidence from randomized controlled trials. We categorized the subject areas evaluated by these reviews and examined their methodology. Utilities and caveats of multiple-indication reviews are illustrated with examples drawn from published literature.

    Results
    We retrieved 52 multiple-indication reviews covering a wide range of interventions. The method has been used to detect unintended effects, improve precision by pooling results across indications, and examine scientific hypotheses across disease classes.

    Conclusion
    Systematic reviews of interventions are typically used to evaluate the effects of treatments, one indication at a time. Here, we argue that, with due attention to methodological caveats, much can be learned by comparing the effects of a given treatment across many related indications.
    Original languageEnglish
    Pages (from-to)1309-1319
    JournalJournal of Clinical Epidemiology
    Volume67
    Issue number12
    Early online date1 Oct 2014
    DOIs
    Publication statusPublished - 1 Dec 2014

    Keywords

    • Multiple-indication reviews
    • Panoramic meta-analyses
    • Research methods
    • Detecting unintended effects
    • Evaluating effectiveness
    • Overviews
    • Assessing harms

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