0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Editorials |

Metabias: A Challenge for Comparative Effectiveness Research

Steven Goodman, MD, MHS, PhD; and Kay Dickersin, MA, PhD
[+] Article and Author Information

From Johns Hopkins University, Baltimore, MD 21205.


Potential Conflicts of Interest: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-1186.

Requests for Single Reprints: Steven Goodman, MD, MHS, PhD, Johns Hopkins University, Oncology Biostatistics, 550 North Broadway, Suite 1103, Baltimore, MD 21205; e-mail, sgoodman@jhmi.edu.

Current Author Addresses: Dr. Goodman: Johns Hopkins University, Oncology Biostatistics, 550 North Broadway, Suite 1103, Baltimore, MD 21205.

Dr. Dickersin: Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205.


Ann Intern Med. 2011;155(1):61-62. doi:10.7326/0003-4819-155-1-201107050-00010
Text Size: A A A

Metabias poses unique challenges for comparative effectiveness research and evidence-based healthcare. Dechartres and colleagues' study in this issue raises the specter of a new metabias that is particularly troubling: that associated with single-center studies. The editorialists explore the implications of these findings and the conundrum that they pose.

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Possible reason for larger effect of single center trials
Posted on July 8, 2011
Stephen J Seligman
New York Medical College
Conflict of Interest: None Declared

The editorial by Goodman and Dickerson (1) discusses the meta- epidemiologic study of Dechartres et al (2) that found a 26% larger effect in single center compared with multicenter trials. The editorial acknowledges that, lacking an independent gold standard, it is not possible to decide whether one or both types of studies are biased. However, multicenter trials are susceptible to intercenter variations absent in single center trials. Of necessity all of these variations cannot improve the reliability of the outcomes. Accordingly, the possibility that single center trials show larger effects is not surprising.

References

1 Goodman S, Dickersin K. Metabias: a challenge for comparative effectiveness research. Ann Intern Med. 2011;155:61-62.

2 Dechartres A, Boutron I, Trinquart L, Charles P, Ravaud P. Single- Center Trials Show Larger Treatment Effects Than Multicenter Trials: Evidence From a Meta-epidemiologic Study. Ann Intern Med. 2011;155:39-51.

Conflict of Interest:

None declared

Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Journal Club
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)