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9.1.3  Why perform a meta-analysis in a review?

The value a meta-analysis can add to a review depends on the context in which it is used, as described in Section 9.1.2. The following are reasons for considering including a meta-analysis in a review.

  1. To increase power. Power is the chance of detecting a real effect as statistically significant if it exists. Many individual studies are too small to detect small effects, but when several are combined there is a higher chance of detecting an effect.

  2. To improve precision. The estimation of an intervention effect can be improved when it is based on more information.

  3. To answer questions not posed by the individual studies. Primary studies often involve a specific type of patient and explicitly defined interventions. A selection of studies in which these characteristics differ can allow investigation of the consistency of effect and, if relevant, allow reasons for differences in effect estimates to be investigated.

  4. To settle controversies arising from apparently conflicting studies or to generate new hypotheses. Statistical analysis of findings allows the degree of conflict to be formally assessed, and reasons for different results to be explored and quantified.

Of course, the use of statistical methods does not guarantee that the results of a review are valid, any more than it does for a primary study. Moreover, like any tool, statistical methods can be misused.