Evidence map›Paper›PMID 32139442›Full record

ArticleEvidence-based mental health2020

Challenges in meta-analyses with observational studies.

Silvia Metelli, Anna Chaimani

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Evidence-based mental health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 144 papers, 69 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
144citing papers in PubMed, 69 pooled it
31.8field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

144 citing papers in PubMed, 69 syntheses or guidelines pooled it, 301 citations in OpenAlex.

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  10. Socioeconomic determinants of overweight and obesity among Mexican children and adolescents: Systematic review and meta-analysis.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2025
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84 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 1 country.

Silvia MetelliUniversité de Paris, Research Center of Epidemiology and Statistics (CRESS-UMR1153), INSERM, INRA, F-75004, Paris, France.
Anna ChaimaniUniversité de Paris, Research Center of Epidemiology and Statistics (CRESS-UMR1153), INSERM, INRA, F-75004, Paris, France anna.chaimani@parisdescartes.fr.ORCID 0000-0003-2828-6832
Délégation Paris 5 · FRInserm · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveMeta-analyses of observational studies are frequently published in the literature, but they are generally considered suboptimal to those involving randomised controlled trials (RCTs) only. This is due to the increased risk of biases that observational studies may entail as well as because of the high heterogeneity that might be present. In this article, we highlight aspects of meta-analyses with observational studies that need more careful consideration in comparison to meta-analyses of RCTs.

methodsWe present an overview of recommendations from the literature with respect to how the different steps of a meta-analysis involving observational studies should be comprehensively conducted. We focus more on issues arising at the step of the quantitative synthesis, in terms of handling heterogeneity and biases. We briefly describe some sophisticated synthesis methods, which may allow for more flexible modelling approaches than common meta-analysis models. We illustrate the issues encountered in the presence of observational studies using an example from mental health, which assesses the risk of myocardial infarction in antipsychotic drug users.

resultsThe increased heterogeneity observed among studies challenges the interpretation of the diamond, while the inclusion of short exposure studies may lead to an exaggerated risk for myocardial infarction in this population.

conclusionsIn the presence of observational study designs, prior to synthesis, investigators should carefully consider whether all studies at hand are able to answer the same clinical question. The potential for a quantitative synthesis should be guided through examination of the amount of clinical and methodological heterogeneity and assessment of possible biases.

Indexed as

Meta-Analysis as TopicObservational Studies as TopicRandomized Controlled Trials as TopicBiomedical ResearchHumans

Identifiers

PMID32139442
PMCPMC10231593
OpenAlexW3009392267

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.