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Percutaneous Dilatational vs Standard Tracheotomy : A Meta-Analysis But Not the Final Analysis

John E. Heffner, MD, FCCP
Author and Funding Information

Affiliations: Charleston, SC 
 ,  Dr. Heffner is Professor of Medicine, Department of Medicine, Medical University of South Carolina.

Correspondence to: John E. Heffner, MD, FCCP, Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, 96 Jonathan Lucas St, PO Box 250623, Charleston, SC 29425; e-mail: heffnerj@musc.edu



Chest. 2000;118(5):1236-1238. doi:10.1378/chest.118.5.1236
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I have developed a fondness for meta-analysis because of the jeopardy we physicians face in thinking we know more about some subjects than we actually do. With 33,000 new citations added to MEDLINE each month, it is no surprise that published reports of new clinical approaches stick in our minds and get entrenched into practice before sufficient evidence establishes their merit. Periodically, a good dose of meta-analysis purges our misperceptions and allows us to see the strength of the evidence—or lack thereof—that underlies our clinical habits. Meta-analysis fulfills its primary role by aggregating data from conflicting or underpowered studies in an attempt to establish statistical evidence of the value of an intervention.1 But to my way of thinking, meta-analysis provides a more important secondary benefit of critically appraising the quality of the data entered into its review. By detecting weaknesses of primary studies and identifying what we don’t know, but think we do, meta-analysis sets research agendas and keeps us from practicing “no-evidence”-based medicine.

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