Avtor/Urednik		Ščuka, Leon
Naslov		Pomen metaanalize v medicini
Prevedeni naslov		Meta-analysis in medicine
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 74, št. 1
Leto izdaje		2005
Obseg		str. 39-48
Jezik		slo
Abstrakt		Background. Meta-analysis is a process of using statistical methods to review and combine the results of different, independent clinical studies. Glass first used the term meta-analysis in 1976 when he and his co-worker Mary Lee Smith statistically combined the results of 3 75 studies that evaluated the efficacy of psychotherapy. Meta-analysis is of particular importance in the assessment of therapeutic efficacy as individual studies do not provide an overview over a topic in its entirety. As their samples are too small, individual studies cannot provide a quantitative evaluation of the effect of treatment, nor can they test the null hypothesis. Prior to meta-analysis, the traditional method was a narrative discourse on previous findings, which, however, could be misleading and subjective. In the past few years, meta-analysis has been increasingly used in all fields of science. T'his is particularly evident in the medical science, where two other terms are used as well - the systematic review and evidence based medicine. Other methods that have advanced markedly are the decision analysis and cost effectiveness analysis. All these methods are connected, and the latter two are an upgrade of the first two. Systematic reviews are exact summaries of the best evidence related to exactly specified clinical dilemmas. Special centres, like the Cochrane Collaboration have been organised in different places around the world, where systematic reviews of scientific literature and their own findings are published in databases collecting data on most appropriate therapies of individual illnesses. These reviews support the synthesis of best evidence for treatment or establishment of best medical practices. In this case, meta-analysis has a broader impact and is not just a statistical method for collecting study results. (Abstract truncated at 2000 characters).
Izvleček		Izhodišča. Metaanaliza je metoda pregledovanja in kombiniranja rezultatov več neodvisnih kliničnih raziskav. Poimenovanje metaanaliza je prvi uporabil Glass leta 1976, ko je s sodelavko Mary Lee Smith statistično združil rezultate 375 študij, ki so obravnavale učinkovitost psihoterapije. Metaanaliza ima poseben pomen pri potrjevanju učinkovitosti zdravljenja, ker posamezne študije ne omogočajo pregleda nad celotno obravnavano problematiko. Po navadi imajo tudi premajhne vzorce, zato ne morejo kvantitativno opredeliti, kakšen je vpliv zdravljenja, niti testirati ničelne hipoteze. Pred obdobjem metaanalize so pripovedno primerjali rezultate študij, kar pa je bilo lahko zavajajoče in subjektivno. V zadnjih letih lahko opazimo povečan obseg opravljenih metaanaliz v vseh vejah znanosti. To še posebej velja za medicino, kjer sta poleg pojma metaanaliza v uporabi še poimenovanji sistematični pregled strokovne literature (systematic review) in na izsledkih temelječa medicina (evidence based medicine). V medicini sta močno napredovali tudi analiza odločanja (decision analysis) ter analiza stroškov in učinkovitosti (cost-effectiveness analysis). Vse naštete metode so medsebojno povezane, zadnji dve pa sta nekakšna nadgradnja prejšnjih. Sistematični pregledi so natančni povzetki najboljših dokazov, ki se nanašajo na natančno določena klinična vprašanja. Ustanovili so posebne centre, npr. Kohranova središča po vsem svetu, ki opravljajo sistematične preglede strokovne literature in objavljajo svoje izsledke v bazah, ki hranijo podatke o najprimernejšem zdrav jenju določenih bolezni. Torej so v pomoč pri sintezi najboljših dokazov za zdravljenje oz. vzpostavljanje najboljše zdravniške prakse. Lahko rečemo, da gre za metaanalizo v širšem smislu, saj jo sicer definirajo samo kot statistično metodo združevanja rezultatov študij. (Izvleček skrajšan pri 2000 znakih).
Deskriptorji		META-ANALYSIS EVIDENCE-BASED MEDICINE DECISION SUPPORT TECHNIQUES