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Meta-mistake: are fragile meta-analyses in ophthalmology worth the high cost?

Eye (2024)Cite this article

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We read with interest the article by Nanji et al., which details that meta-analyses in ophthalmology are frequently fragile, and their statistical significance hinges on the event status of very few patients [1]. We would like to add to this finding with information regarding the relevance of meta-analyses within ophthalmology and how we could improve their overall reliability (Table 1).

Table 1 List of recommendations to enhance the reliability and utility of meta-analyses in ophthalmology.
Full size table

Meta-analyses were originally written to compile data across publications with similar research aims, to increase robustness and reliability of scientific research as a whole. However, with the current ease of reviewing literature, abundance of analytical software to simplify this process, new statistical techniques to generate different types of meta-analyses, and the relative accessibility given that meta-analyses do not require a lab setting, the number of meta-analyses published across all fields have starkly increased especially during the COVID-19 pandemic [2].

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References

  1. Nanji K, Xie J, Hatamnejad A, Pur DR, Phillips M, Zeraatkar D, et al. Exploring the fragility of meta-analyses in ophthalmology: a systematic review. Eye 2024. https://doi.org/10.1038/s41433-024-03255-2.

  2. Deo SV, Deo VS. Systematic review and meta-analysis: a brief introduction. Indian J Thorac Cardiovas Surg. 2022;38:342–5.

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Funding

RA is supported by grants awarded by the National Medical Research Council (NMRC), Ministry of Health, Republic of Singapore, grant number NMRC/CSAINV22jul-0004, NMRC/CSAINV19nov-0007, and NMRC/CIRG21nov-0023. The funders had no role in this study design, data collection and analysis, publication decisions, or manuscript preparation.

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Authors and Affiliations

  1. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Mattias Wei Ren Kon

  2. Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, Singapore

    William Rojas-Carabali, Carlos Cifuentes-Gonzalez & Rupesh Agrawal

  3. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore

    William Rojas-Carabali & Rupesh Agrawal

Authors
  1. Mattias Wei Ren Kon
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  2. William Rojas-Carabali
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  3. Carlos Cifuentes-Gonzalez
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  4. Rupesh Agrawal
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Contributions

WRC: Conceptualised, draughted, and reviewed the manuscript. MWRK: Conceptualised, draughted, and edited the manuscript. CCG and RA: Provided expert comments and suggestions and reviewed the manuscript. All authors approved the final version of the manuscript.

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Correspondence to Rupesh Agrawal.

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Kon, M.W.R., Rojas-Carabali, W., Cifuentes-Gonzalez, C. et al. Meta-mistake: are fragile meta-analyses in ophthalmology worth the high cost?. Eye (2024). https://doi.org/10.1038/s41433-024-03331-7

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  • DOI: https://doi.org/10.1038/s41433-024-03331-7

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