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Annals of Oncology 7:1009-1014, 1996
© 1996 European Society for Medical Oncology

other

Meta-analysis and prospective meta-analysis in childhood leukemia clinical research

J. J. Shuster and P. W. Gieser

Pediatric Oncology Group Statistical Office, Department of Statistics, Universiy of Florida Gainesville, FL, USA

Correspondence to: Jonathan J. Shuster, PhD Pediatric Oncology Group Statistical Office Department of Statistics University of Florida 104 N. Main St. 600 Gainesville, FL 32601 USA

In this paper, we consider the role of meta-analysis and ‘prospective meta-analysis’ studies in childhood acute lymphocytic leukemia (ALL). In this issue, Valsecchi and Masera [1] give a thoughtful discourse, generally favorable to this approach. This article presents the opposite point of view. The aims of our article are to present the implications in clinical, rather than biostatistical terms, and to provide an extensive literature review of the subject of meta-analysis.

We conclude that treatment assessments, resulting from meta-analysis of closed studies (retrospective) should be met with healthy skepticism. Trials requiring international resources should be true intergroup trials with a single coordinating center, rather than prospective meta-analysis, unless it is a question grafted onto each group's own research agenda. For example, each group might ask its own systemic control question, but a CNS protection question is asked collectively.

acute lymphoblastic leukemia, fixed effects, meta-analysis, random effects, randomization


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