A guide to interpreting systematic reviews and meta-analyses in neurosurgery and surgery

Introduction Systematic reviews (SRs) and meta-analyses (MAs) are methods of data analysis used to synthesize information presented in multiple publications on the same topic. A thorough understanding of the steps involved in conducting this type of research and approaches to data analysis is critic...

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Bibliographic Details
Published in:	Acta neurochirurgica Vol. 166; no. 1; p. 250
Main Authors:	Esene, Ignatius, Tantengco, Ourlad Alzeus G., Robertson, Faith C., Still, Megan E. H., Ukachukwu, Alvan-Emeka K., Baticulon, Ronnie E., Barthélemy, Ernest J., Perez-Chadid, Daniela, Lippa, Laura, Silva, Ana Cristina Veiga, Jokonya, Luxwell, Hassani, Fahd D., Nicolosi, Federico, Takoutsing, Berjo D., Ntalaja, Jeff, Hoz, Samer S., Kalangu, Kazadi K. N., Dechambenoit, Gilbert, Servadei, Franco, El Abbadi, Najia, Park, Kee B., Kolias, Angelos
Format:	Journal Article
Language:	English
Published:	Vienna Springer Vienna 04-06-2024 Springer Nature B.V
Subjects:	Brain tumors Data analysis Data Interpretation, Statistical Humans Interventional Radiology Medicine Medicine & Public Health Meta-analysis Meta-Analysis as Topic Mini-review (by Invitation) Minimally Invasive Surgery Neurology Neuroradiology Neurosurgery Neurosurgical Procedures - methods Surgical Orthopedics Systematic Reviews as Topic - methods Evidence-based neurosurgery Systematic review Forest plot Neurosurgery Surgery Meta-analysis
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Summary:	Introduction Systematic reviews (SRs) and meta-analyses (MAs) are methods of data analysis used to synthesize information presented in multiple publications on the same topic. A thorough understanding of the steps involved in conducting this type of research and approaches to data analysis is critical for appropriate understanding, interpretation, and application of the findings of these reviews. Methods We reviewed reference texts in clinical neuroepidemiology, neurostatistics and research methods and other previously related articles on meta-analyses (MAs) in surgery. Based on existing theories and models and our cumulative years of expertise in conducting MAs, we have synthesized and presented a detailed pragmatic approach to interpreting MAs in Neurosurgery. Results Herein we have briefly defined SRs sand MAs and related terminologies, succinctly outlined the essential steps to conduct and critically appraise SRs and MAs. A practical approach to interpreting MAs for neurosurgeons is described in details. Based on summary outcome measures, we have used hypothetical examples to illustrate the Interpretation of the three commonest types of MAs in neurosurgery: MAs of Binary Outcome Measures (Pairwise MAs), MAs of proportions and MAs of Continuous Variables. Furthermore, we have elucidated on the concepts of heterogeneity, modeling, certainty, and bias essential for the robust and transparent interpretation of MAs. The basics for the Interpretation of Forest plots, the preferred graphical display of data in MAs are summarized. Additionally, a condensation of the assessment of the overall quality of methodology and reporting of MA and the applicability of evidence to patient care is presented. Conclusion There is a paucity of pragmatic guides to appraise MAs for surgeons who are non-statisticians. This article serves as a detailed guide for the interpretation of systematic reviews and meta-analyses with examples of applications for clinical neurosurgeons.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23
ISSN:	0001-6268 0942-0940 0942-0940
DOI:	10.1007/s00701-024-06133-8