0
Debate in Print |

Is Meta-analysis a Metaphysical or a Scientific Method?*

Rodrigo Arriagada, MD; Jean-Pierre Pignon, MD, PhD
Author and Funding Information

*From the Department of Radiation Oncology (Dr. Arriagada), Instituto de Radiomedicina, Santiago, Chile; and the Department of Biostatistics (Dr. Pignon), Institut Gustave-Roussy, Villejuif, France.

Correspondence to: Rodrigo Arriagada, MD, Instituto de Radiomedicina, Américo Vespucio Norte 1314, Vitacura, Santiago, Chile; e-mail: gocchi@ctcinternet.cl



Chest. 2000;118(3):832-834. doi:10.1378/chest.118.3.832
Text Size: A A A
Published online

Extract

Knowledge can progress only if people have open minds and test their ideas.1

Richard Feynman

Machtay et al2 recently published a criticism of the study by the PORT (postoperative radiotherapy) Meta-analysis Trialists Group3 of patients with non-small cell lung cancer (NSCLC). As coauthors of this study, we would like to address some of the general and specific concerns of our colleagues. In the title, Machtay et al2 suggested that meta-analysis could be close to metaphysics, but they did not elaborate on this subject. Meta-analysis is a method of quantitative evaluation used mostly in epidemiology, psychology, and the medical sciences. As with all methods of measure, it is always necessary to consider its advantages and disadvantages in the whole process of scientific evaluation. Meta-analysis, however, cannot be related to metaphysics, which it is another area of knowledge. Popper4 defined the sharpest demarcation between science and metaphysics, defining testability as the criterion of demarcation. So, if a hypothesis is testable, it might be included in the scientific field if the tools for testing it are available. The hypothesis that postoperative radiotherapy may have a survival effect on surgically resected NSCLC patients can be tested through comparative unconfounded clinical trials that have sufficient statistical power. Unfortunately, the radiation oncology community is largely responsible for having treated hundreds of thousands of patients with postoperative radiotherapy without testing the usefulness of the treatment, and so, in 30 years of worldwide experience, not> 3,000 patients have been included in comparative randomized trials. Because of the absence of a well-conducted and planned mega-trial, as all scientists would like, we decided, in cooperation with the Medical Research Council, to perform an individual data-based meta-analysis of randomized trials. The main reason for the study was that postoperative radiotherapy had been performed largely only on the basis of the scarce results of individual trials or on retrospective experiences, with all the related widely well-known biases of those modalities.5

First Page Preview

View Large
First page PDF preview

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

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).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543