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We calculated the p-value for the most precise trial and meta-analysis.
The estimates of effect for the most precise trial and meta-analysis were generally similar.
Finally as suggested in Figure 1, even if the most precise trial is identified, it still needs to be critically appraised, and, if unacceptably flawed, the second most precise trial examined, etc.
Figure 3 shows the comparison of p-values from the most precise trial and the meta-analysis.
It may be prudent for systematic reviewers to check agreement of the most precise trial and the meta analysis.
For clinicians using trials we suggest that when a meta-analysis is not available, a focus on the most precise trial is reasonable provided it is adequately powered.
Similar(41)
Finally, we explored the use of the single most precise trials and found that the proposed test had fair power.
Single most precise trials provided similar estimates of effects to those of the meta-analyses to which they contributed, and statistically significant results are generally in agreement.
There is disparity between the overall combined effect on LoS as compared with the negative results from the largest and most precise trials.
The overall results are contradicted by the largest and most precise trials, both of which estimate virtually no difference between the groups.
This "disagreement" is less surprising, as many of these most precise trials were still clearly underpowered for the key outcome measure.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com