Journal Review

This week we begin our journey of information sharing.

We generally believe that a meta analysis is the ultimate guide or benchmark for evidence based practice.
Koster et al published an interesting review titled
Systematic overview and critical appraisal of meta-analyses of interventions in intensive care medicine 
This was published in Acta Anaesthesiologica Scandinavica
The authors raised a pertinent question regarding the critical appraisal method of the RCTs included in several often quoted meta analyses pertaining to the field of Intensive Care Medicine.
Out of a total of 467 meta analyses identified, only 1 in 9 satisfied basic scientific criteria for analysis. Out of these 56 or so meta analyses only 4 (four)  0.9% showed a low risk of bias. The rest of the analyses had a bias component which makes their interpretation complicated.

My opinion: It is good to rely on a meta analysis to guide some decisions in practice. However, we should be able to understand the scientific strength of the RCTs included so that we don't get caught in the "Garbage in Garbage out" phenomenon.