ArticleBMC medical research methodology2009
Evidence synthesis as the key to more coherent and efficient research.
Article in BMC medical research methodology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Characterization changes and research waste in randomized controlled trials of global gastroesophageal reflux disease and hiatus hernia over the past 20 years.International journal of surgery (London, England) · 2025Pooled it
- Deficiencies in the transfer and availability of clinical trials evidence: a review of existing systems and standards.BMC medical informatics and decision making · 2012Pooled it
- Development and Evaluation of a Generative AI Chatbot for Database Searching in Systematic Review.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2026Article
- Artificial Intelligence and Automation in Evidence Synthesis: An Investigation of Methods Employed in Cochrane, Campbell Collaboration, and Environmental Evidence Reviews.Cochrane evidence synthesis and methods · 2025Article
- Experiences of novice student team members in evidence synthesis: Study protocol for a study within a review.HRB open research · 2025Article
- Problematic meta-analyses: Bayesian and frequentist perspectives on combining randomized controlled trials and non-randomized studies.BMC medical research methodology · 2024Article
- Quality Assessment and Relevant Clinical Impact of Randomized Controlled Trials of Varicocele: Next Step to Good-Quality Randomized Controlled Trial of Varicocele Treatment.The world journal of men's health · 2022Article
- Barriers and Facilitating Factors for Conducting Systematic Evidence Assessments in Academic Clinical Trials.JAMA network open · 2021Article
- Randomized controlled trials on erectile dysfunction: quality assessment and relevant clinical impact (2007-2018).International journal of impotence research · 2020Article
- Evidence synthesis for constructing directed acyclic graphs (ESC-DAGs): a novel and systematic method for building directed acyclic graphs.International journal of epidemiology · 2020Article
- Corrigendum to: Evidence synthesis for constructing directed acyclic graphs (ESC-DAGs): a novel and systematic method for building directed acyclic graphs.International journal of epidemiology · 2020Article
- Methods used to assess outcome consistency in clinical studies: A literature-based evaluation.PloS one · 2020Article
- Evidence synthesis in prognosis research.Diagnostic and prognostic research · 2019Article
- Use of a random effects meta-analysis in the design and analysis of a new clinical trial.Statistics in medicine · 2018Article
- Article
- Planning a future randomized clinical trial based on a network of relevant past trials.Trials · 2018Article
- Is the information of systematic reviews published in nursing journals up-to-date? a cross-sectional study.BMC medical research methodology · 2017Article
- The INVEST project: investigating the use of evidence synthesis in the design and analysis of clinical trials.Trials · 2017Article
- Quality analysis of randomized controlled trials in the International Journal of Impotence Research: quality assessment and relevant clinical impact.International journal of impotence research · 2017Article
- The pathway to RCTs: how many roads are there? Examining the homogeneity of RCT justification.Trials · 2017Review
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundSystematic review and meta-analysis currently underpin much of evidence-based medicine. Such methodologies bring order to previous research, but future research planning remains relatively incoherent and inefficient.
methodsTo outline a framework for evaluation of health interventions, aimed at increasing coherence and efficiency through i) making better use of information contained within the existing evidence-base when designing future studies; and ii) maximising the information available and thus potentially reducing the need for future studies.
resultsThe framework presented insists that an up-to-date meta-analysis of existing randomised controlled trials (RCTs) should always be considered before future trials are conducted. Such a meta-analysis should inform critical design issues such as sample size determination. The contexts in which the use of individual patient data meta-analysis and mixed treatment comparisons modelling may be beneficial before further RCTs are conducted are considered. Consideration should also be given to how any newly planned RCTs would contribute to the totality of evidence through its incorporation into an updated meta-analysis. We illustrate how new RCTs can have very low power to change inferences of an existing meta-analysis, particularly when between study heterogeneity is taken into consideration.
conclusionWhile the collation of existing evidence as the basis for clinical practice is now routine, a more coherent and efficient approach to planning future RCTs to strengthen the evidence base needs to be developed. The framework presented is a proposal for how this situation can be improved.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.