PURPOSE OF REVIEW: Meta-analysis provides the highest level of evidence-based efficacy of a medical treatment or intervention. Allergen immunotherapy in its two forms of subcutaneous immunotherapy and sublingual immunotherapy (SLIT) is an effective treatment of respiratory allergy as shown by meta-analyses, but in recent years there has been an overflow of meta-analyses on SLIT, with contrasting results that may generate confusion among physicians. RECENT FINDINGS: It can be observed that flaws are often present in meta-analyses including: incorrect selection of trials, inappropriate use of evaluation parameters for the analysis, and unsuitable analyses. For instance, it is clear that a meta-analysis of several small studies does not predict the results of a single large study that remains the gold standard to assess the efficacy and safety of a treatment. To assess the interest of the matter, we calculated the number of citations of meta-analyses on SLIT efficacy in the 10 years after the first publication in 2005 and detected a continuous decrease in citations. SUMMARY: Today, the appropriateness of a meta-analysis should be carefully evaluated, taking into account that a meta-analysis uses a statistical approach to combine the results from multiple small studies to increase power, to improve estimates of the size of the effect, and/or to resolve uncertainty when reports disagree. Editors and reviewers of medical journals should consider that to judge a meta-analysis requires a high level of expertise that is obvious in reviewers belonging to the Cochrane organization.

The current overuse and misuse of meta-analyses on sublingual immunotherapy: the case of grass pollen allergy / Ridolo, Erminia; Incorvaia, Cristoforo; Gritti, Bruna Luciana; Passalacqua, Giovanni. - In: CURRENT OPINION IN ALLERGY AND CLINICAL IMMUNOLOGY. - ISSN 1528-4050. - (2016), p. 1. [10.1097/ACI.0000000000000330]

The current overuse and misuse of meta-analyses on sublingual immunotherapy: the case of grass pollen allergy

RIDOLO, Erminia;
2016

Abstract

PURPOSE OF REVIEW: Meta-analysis provides the highest level of evidence-based efficacy of a medical treatment or intervention. Allergen immunotherapy in its two forms of subcutaneous immunotherapy and sublingual immunotherapy (SLIT) is an effective treatment of respiratory allergy as shown by meta-analyses, but in recent years there has been an overflow of meta-analyses on SLIT, with contrasting results that may generate confusion among physicians. RECENT FINDINGS: It can be observed that flaws are often present in meta-analyses including: incorrect selection of trials, inappropriate use of evaluation parameters for the analysis, and unsuitable analyses. For instance, it is clear that a meta-analysis of several small studies does not predict the results of a single large study that remains the gold standard to assess the efficacy and safety of a treatment. To assess the interest of the matter, we calculated the number of citations of meta-analyses on SLIT efficacy in the 10 years after the first publication in 2005 and detected a continuous decrease in citations. SUMMARY: Today, the appropriateness of a meta-analysis should be carefully evaluated, taking into account that a meta-analysis uses a statistical approach to combine the results from multiple small studies to increase power, to improve estimates of the size of the effect, and/or to resolve uncertainty when reports disagree. Editors and reviewers of medical journals should consider that to judge a meta-analysis requires a high level of expertise that is obvious in reviewers belonging to the Cochrane organization.
The current overuse and misuse of meta-analyses on sublingual immunotherapy: the case of grass pollen allergy / Ridolo, Erminia; Incorvaia, Cristoforo; Gritti, Bruna Luciana; Passalacqua, Giovanni. - In: CURRENT OPINION IN ALLERGY AND CLINICAL IMMUNOLOGY. - ISSN 1528-4050. - (2016), p. 1. [10.1097/ACI.0000000000000330]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11381/2820220
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