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A meta-analysis of trials comparing primary treatment with or without chemotherapy for patients with non-small cell lung cancer published in 1995 suggested a survival benefit for cisplatin-based chemotherapy in each of the primary treatment settings studied, but it included many small trials, and trials with differing eligibility criteria and chemotherapy regimens.
Because of the susceptibility to publication bias, and previous instances in which subsequent trials contradicted results of meta-analyses of small trials, clinicians are legitimately skeptical about considering a meta-analysis of many small trials as providing definitive evidence.
The benefits of garlic supplementation also remain unproven, with many small trials reporting only short-term BP improvements [ 7, 18].
For that reason investigators have conducted meta-analyses of many small trials to try to identify any previously unknown adverse effects.
Furthermore, the inclusion in a meta-analysis of many small trials with a very low number of events poses challenging problems in statistical analysis (12– 12).
There is a clear need to improve survival for patients undergoing major surgery [ 2, 3], and in many small trials, GDT has been associated with better clinical outcomes, particularly following high-risk procedures [ 4- 6].
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As a result, efforts have been made to pool the results of many smaller trials to look for safety problems.
Many small-scale trials show vaccines are effective.
When experimenting with blends, winemakers and their associates do many small-scale trials until reaching a consensus.
Of course not every idea can or should be tested (for me, that conversation is long and dull) but here is an opportunity – which hopefully is one of many small concurrent trials to investigate inventive ways to increase breastfeeding rates – to cheaply, quickly and positively answer a question which could be of benefit to millions of women and their babies.
Distributions for the number of participants in both African and North American trials were positively skewed with many more small trials than large trials.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com