Conclusive meta-analyses on antenatal magnesium may be inconclusive! Are we underestimating the risk of random error?

Authors

  • JESPER BROK,

    1. Department of Pediatrics, Rigshospitalet, Copenhagen University Hospitals, Copenhagen, Denmark
    2. The Copenhagen Trial Unit, Center for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospitals, Copenhagen, Denmark
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  • LENE D. HUUSOM,

    1. Department of Gynecology and Obstetrics, Hvidovre Hospital, Copenhagen University Hospitals, Hvidovre, Denmark
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  • KRISTIAN THORLUND

    1. The Copenhagen Trial Unit, Center for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospitals, Copenhagen, Denmark
    2. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
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  • Conflict of interest
    The authors have stated explicitly that there are no conflicts of interest in connection with this article.

  • Please cite this article as: Brok J, Huusom LD, Thorlund K. Conclusive meta-analyses on antenatal magnesium may be inconclusive! Are we underestimating the risk of random error? Acta Obstet Gynecol Scand 2012; 91:1247–1251.

Jesper Brok, Department of Pediatrics, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen Ø, 2100 Denmark. E-mail: jesperb5@hotmail.com

Abstract

Results from meta-analyses significantly influence clinical practice. Both simulation and empirical studies have demonstrated that the risk of random error (i.e. spurious chance findings) in meta-analyses is much higher than previously anticipated. Hence, authors and users of systematic reviews and meta-analyses have a responsibility to carefully consider the risk of random errors to avoid misleading conclusions. Trial sequential analysis is a useful meta-analytic method for gauging the risk of random error in meta-analysis and the amount of additional evidence required to reach firm conclusions about the investigated intervention effect(s). We outline the rationale for conducting trial sequential analysis including some examples of the meta-analysis on antenatal magnesium for women at risk of preterm birth.

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