meta-analysis

The Hunger Code: How to Reset Your Body's Fat Thermostat by Breaking the Ultra-Processed Food Habit

by Jason Fung  · 3 Mar 2026  · 284pp  · 76,656 words

.21 Protein supplements also don’t help weight loss after bariatric surgery, and neither do they seem to improve muscle mass significantly.22 And a meta-analysis similarly showed a lack of benefit for weight loss in post-menopausal women.23 As with carbohydrates, the food matrix (the physical structure of the

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.3 pounds). More stunning is that average weight loss increased over the six-month follow-up period to 9.2 kg (20 pounds)!16 Another meta-analysis of studies estimated that mindful eating reduces weight by 6.8 pounds (3.1 kg) on average and 7.5 pounds (3.4 kg) at

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Beaulieu K et al. Effect of exercise training interventions on energy intake and appetite control in adults with overweight or obesity: a systematic review and meta-analysis. Obes Rev. 2021 Jul;22 (Suppl 4):e13251. doi: 10.1111/obr.13251. Chapter 2: Regulating the Body Fat Thermostat 1 Bray GA. The pain

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):E1160–6. doi: 10.1152/ajpendo.90637.2008. 12 Zurbau A et al. Oat beta-glucan and postprandial blood glucose regulation: a systematic review and meta-analysis of acute, single-meal feeding, controlled trials. Curr Dev Nutr. 2020 May 29;4(Suppl 2):677. doi: 10.1093/cdn/nzaa049_070. 13 Xiong

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K et al. Effects of resistant starch on glycaemic control: a systematic review and meta-analysis. Br J Nutr. 2021 Jun 14;125(11):1260–9. doi: 10.1017/S0007114520003700. 14 Sonia S et al. Effect of cooling of cooked white

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.2018.04.010. 49 Rovira-Llopis S et al. Circadian alignment of food intake and glycaemic control by time-restricted eating: A systematic review and meta-analysis. Rev Endocr Metab Disord. 2024 Apr;25(2):325–37. doi: 10.1007/s11154-023-09853-x. 50 Jamshed H et al. Effectiveness of early

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/j.metabol.2018.04.001. 11 Lin J et al. Associations of short sleep duration with appetite-regulating hormones and adipokines: a systematic review and meta-analysis. Obes Rev. 2020 Nov;21(11):e13051. doi: 10.1111/obr.13051. 12 Schmid SM et al. A single night of sleep deprivation increases ghrelin

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4;175:389–91. 8 Harcombe Z et al. Evidence from prospective cohort studies does not support current dietary fat guidelines: a systematic review and meta-analysis. Br J Sports Med. 2017 Dec;51(24):1743–9. doi: 10.1136/bjsports-2016-096550. 9 Hu FB et al. Dietary fat intake and

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:103220. doi: 10.1016/j.amsu.2021.103220. 23 Kuo YY et al. Effect of whey protein supplementation in postmenopausal women: a systematic review and meta-analysis. Nutrients. 2022 Oct 10;14(19):4210. doi: 10.3390/nu14194210. 24 Rezaie P et al. Effects of bitter substances on GI function, energy intake

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. doi: 10.1016/j.jnutbio.2010.06.006. 29 Hursel R et al. The effects of green tea on weight loss and weight maintenance: a meta-analysis. Int J Obes (Lond). 2009 Sep;33(9):956–61. doi: 10.1038/ijo.2009.135. 30 Rudelle S et al. Effect of a thermogenic

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.1093/ajcn/70.6.1040. 32 Hursel R et al. The effects of catechin rich teas and caffeine on energy expenditure and fat oxidation: a meta-analysis. Obes Rev. 2011 Jul;12(7):e573–81. doi: 10.1111/j.1467-789X.2011.00862.x. 33 Rumpler W et al. Oolong tea increases

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/jn/131.11.2848. 34 Phung OJ et al. Effect of green tea catechins with or without caffeine on anthropometric measures: a systematic review and meta-analysis. Am J Clin Nutr. 2010 Jan;91(1):73–81. doi: 10.3945/ajcn.2009.28157. 5 Jurgens TM et al. Green tea for weight

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Aug;16(8):1894–900. doi: 10.1038/oby.2008.284. 44 Azad MB et al. Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. CMAJ. 2017 Jul 17;189(28):E929–39. doi: 10.1503/cmaj.161390. 45 Eweis DS et

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/nu13082779. 20 Silva Júnior AE, Macena ML, Bueno NB. The prevalence of food addiction and its association with type 2 diabetes: a systematic review with meta-analysis. Br J Nutr. 2025 Feb 28;133(4):558–66. doi:10.1017/S000711452500008X. 21 Burmeister JM et al. Food addiction in adults seeking weight

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. 1990 Aug;14(8):679–88. 29 Kahathuduwa CN et al. Extended calorie restriction suppresses overall and specific food cravings: a systematic review and a meta-analysis. Obes Rev. 2017 Oct;18(10):1122-1135. doi: 10.1111/obr.12566. 30 Unwin J et al. Low carbohydrate and psychoeducational programs show promise

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: associations with adult obesity. J Acad Nutr Diet. 2017 Jun;117(6):937–45. 13 Robinson E et al. Eating attentively: a systematic review and meta-analysis of the effect of food intake memory and awareness on eating. Am J Clin Nutr. 2013 Apr;97(4):728–42. doi: 10.3945/ajcn

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(5):392–396. doi: 10.1111/1467-9280.00073. 16 Rogers JM et al. Mindfulness-based interventions for adults who are overweight or obese: a meta-analysis of physical and psychological health outcomes. Obes Rev. 2017 Jan;18(1):51–67. doi: 10.1111/obr.12461. 17 Carrière K et al. Mindfulness

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-based interventions for weight loss: a systematic review and meta-analysis. Obes Rev. 2018 Feb;19(2):164–77. doi: 10.1111/obr.12623. 18 Paturel A. Bolster your brain by stimulating the vagus nerve. Cedars

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.2013.11.002. 14 Jonas WB et al. To what extent are surgery and invasive procedures effective beyond a placebo response? A systematic review with meta-analysis of randomised, sham controlled trials. BMJ Open. 2015 Dec 11;5(12):e009655. doi: 10.1136/bmjopen-2015-009655. 15 Crum AJ et al. Mind

Blank Space: A Cultural History of the Twenty-First Century

by W. David Marx  · 18 Nov 2025  · 642pp  · 142,332 words

. Forbes, Jayna M. Holroyd-Leduc, Marc J. Poulin, and David B. Hogan, “Effect of Nutrients, Dietary Supplements and Vitamins on Cognition: A Systematic Review and Meta-Analysis of Randomized Controlled Trials,” Canadian Geriatrics Journal 18, no. 4 (2015): 231–45, https://doi.org/10.5770/cgj.18.189; Julia Belluz, “How Dietary

Fixed: Why Personal Finance is Broken and How to Make it Work for Everyone

by John Y. Campbell and Tarun Ramadorai  · 25 Jul 2025

A large academic literature has sought to measure the effects of financial literacy education. A widely cited 2022 paper summarizes the results by conducting a meta-analysis, combining the findings of many individual studies to achieve greater precision.9 The conclusion is that educational interventions to improve financial literacy have effects on

Mattering: The Secret to Building a Life of Deep Connection and Purpose

by Jennifer Breheny Wallace  · 13 Jan 2026  · 206pp  · 68,830 words

. 113 Neuroimaging studies find: Sylvia A. Morelli, Matthew D. Sacchet, and Jamil Zaki, “Common and Distinct Neural Correlates of Personal and Vicarious Reward: A Quantitative Meta-Analysis,” NeuroImage 112 (May 2015): 244–53. 113 feels authentic delight: Jeremy Adam Smith, “What Is Sympathetic Joy and How Can You Feel More of It

Human Diversity: The Biology of Gender, Race, and Class

by Charles Murray  · 28 Jan 2020  · 741pp  · 199,502 words

. The same thing happens within different kinds of STEM occupations: In 2015, two of the same authors, Rong Su and James Rounds, conducted another meta-analysis focusing on distinctions within scientific and technical occupations. Again, their database of vocational preferences and a database of actual jobs held by the U.S

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: Women have a pronounced neurological tendency to respond to negative stimuli; men have a pronounced neurological tendency to respond to positive stimuli. The Stevens meta-analysis is useful for establishing the reality of an overall relationship—in this case between regional sex differences in the brain and emotional response—but the

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But the most extensive technical literature involves the Big Five personality factors—emotional stability, extraversion, conscientiousness, openness, and agreeableness—so much that a 2014 meta-analysis of the relationship of personality to academic performance by psychologist Arthur Poropat had two dozen samples to work with. Conscientiousness consistently played the most important

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Psychological Bulletin by a team of psychologists at the University of Minnesota (first author was Paul Sackett). The authors presented results for a meta-analysis of College Board data, a meta-analysis of other studies using a composite measure of parental SES, and a reanalysis of major longitudinal datasets. A table summarizing the results

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controlling for the admissions test score, the correlation of parental SES and college grades dropped from +.22 to –.01 in the SAT meta-analysis, from .09 to .00 in the meta-analysis of studies with composite SES measures, and from a mean of .06 to .01 among the longitudinal studies. After controlling for the

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measure of SES, the correlation between admission test score and grades was reduced only fractionally: from +.53 to +.50 in the SAT meta-analysis, from +.37 to +.36 in the meta-analysis of studies with composite SES measures, and from a mean of +.313 to +.308 among the longitudinal studies. For practical purposes, parental

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environment can be affected by outside interventions.” “But you’re ignoring epigenetics!” “The First Premise Is Wrong for Some Important Outcomes” In the Polderman meta-analysis discussed in chapter 11, there were exceptions to the generalization that the role of the shared environment is trivially small. The shared environment explained 36

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The authors conducted extensive tests for the robustness of this finding, all of which it passed. Their main conclusion is worth quoting in full: This meta-analysis of published and unpublished data provided clear answers to our three questions. First, studies from the United States supported a moderately sized Gene × SES

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settings with conditions most similar to operational testing is small and inflated by publication bias.39 Given this assessment from the largest and most rigorous meta-analysis of a quarter century of attempts to demonstrate stereotype threat, it seems unlikely that a significant role for stereotype threat exists. The Growth Mindset

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mindset and academic achievement? Is there evidence that growth mindset interventions produce improvements in academic achievement? The relationship of growth mindset to academic achievement. This meta-analysis analyzed the results of 273 studies with a combined sample of 365,915. The mean correlation between growth mindset and academic achievement was .10.

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the literature had grown so large that an international team of neuroscientists drawn primarily from Cambridge University (first author was Amber Ruigrok) could publish “A Meta-analysis of Sex Differences in Human Brain Structure” that combined 77 different studies involving 14,597 individuals. The table below shows the results for the basic

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volume measures. META-ANALYSIS OF SEX DIFFERENCES IN THE MAJOR VOLUMES Volume: Intracranial volume Studies: 77 Sample size: 14,957 Mean difference (ml): 135.3 Percentage difference: 12

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of articles that Maccoby and Jacklin had underestimated the role of differential socialization (e.g., Block (1978), Block (1983)). Lytton and Romney (1991), a subsequent meta-analysis of 172 studies of gender socialization, examined socialization regarding eight topics: amount of interaction, achievement encouragement, warmth, nurturance, responsiveness (including praise), encouragement of dependency,

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restrictiveness/low encouragement of independence, disciplinary strictness, encouragement of sex-typed activities, sex-typed perception, and clarity of communication/use of reasoning. The meta-analysis found few differences on any of them. “The effect sizes for most socialization areas are nonsignificant and generally very small, fluctuating in direction across studies

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0.43 (boys got more encouragement) and the effect size for physical punishment was –0.37 (boys got more physical punishment). Seven years later, another meta-analysis, Leaper, Anderson, and Sanders (1998), focused specifically on studies that observed the language that parents use with their children. There were sex differences in the

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, van Aken et al. (2006); Rothbaum and Weisz (1994); Kawabata, Alink, Tseng et al. (2011). In 2016, the Dutch scholars cited earlier published a meta-analysis of the literature on gender-differentiating parenting regarding control strategies. Their conclusion was generically similar to those of the other meta-analyses: The evidence showed

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56 studies limited to those that report direct contrasts between men and women participating in the same visual emotion-eliciting task within each study. The meta-analysis focused on which regions were activated, with broad characterizations of the results rather than specific hypotheses about how they related to phenotypic differences. Here

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in females in early puberty before peaking and decreasing, while males show increasing amygdala volumes throughout puberty. Marwha, Halari, and Eliot (2017), a recent meta-analysis that found no significant difference in amygdala size after correcting for total brain volume, disputes this, reporting that “our findings do not support a marked

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a 10% downward bias in the reported estimates of h2 in comparison to those based on twin correlations, consistent with the observed discrepancy between our meta-analysis of variance component estimates calculated from twin correlations and the reported variance components.” Polderman, Benyamin, de Leeuw et al. (2015): 705. 15. Plomin (2011):

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The results are limited to meta-analyses incorporating corrections for restriction of range and criterion unreliability using conservative criterion reliability estimates. When more than one meta-analysis reported operational validities for a given category, I report the mean of those results. The chapter also includes analyses comparing the operational validities of different

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various positions would take us deep into the psychometric weeds. For me, a single source that is both rigorous and judicious is a 2010 integrative meta-analysis by psychologists Dana Joseph and Daniel Newman. They conclude the article with “Practical Advice for Using Emotional Intelligence Measures in Personnel Selection” that seems

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. 36. The table below is adapted from Sackett, Kuncel, Arneson et al. (2009): Table 4. The figures for the SAT meta-analysis are corrected for national population range restriction. Sample: Meta-analysis of College Board data Correlation N: SES–test: +.42 SES–grade: +.22 Test–grade: +.53 Partial correlation Test–grade controlling for

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stereotyped students performed better than nonstereotyped students) for tests under “safe conditions that reduce threat.” (p. 1137). The study also reported results from a meta-analysis of 39 samples that included several studies of race-based stereotype threat but did not break out separate effect sizes for the race-based studies

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. (2015), restricting them to ones with samples of healthy adults and correcting for restriction of range. They reached an estimated correlation of +.31. The 2017 meta-analysis also classified studies according to their quality of measurement—“fair,” “good,” and “excellent.” The estimated correlations for these subsets were +.23, +.32, and +.39

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Biology and Medicine.” Lancet 392 (10149): 777–86. Doyle, Randi A., and Daniel Voyer. 2016. “Stereotype Manipulation Effects on Math and Spatial Test Performance: A Meta-Analysis.” Learning and Individual Differences 47: 103–16. Duckworth, Angela Lee, and Stephanie M. Carlson. 2013. “Self-Regulation and School Success.” In Self-Regulation and

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New York: Springer Science + Business Media. Flore, Paulette C., and Jelte M. Wicherts. 2015. “Does Stereotype Threat Influence Performance of Girls in Stereotyped Domains? A Meta-analysis.” Journal of School Psychology 53 (1): 25–44. Foley, Sallie, and George W. Morley. 1992. “Care and Counseling of the Patient with Vaginal Agenesis.” The

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Science Fictions: How Fraud, Bias, Negligence, and Hype Undermine the Search for Truth

by Stuart Ritchie  · 20 Jul 2020

circulate). Boldt’s faked results made it look as if hydroxyethyl starch was safe for this purpose, a verdict bolstered by the fact that a ‘meta-analysis’ – a review study that pools together all the previous papers on the subject – reached the same conclusion. This was only true, however, because Boldt

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’s fraud hadn’t yet been revealed; the meta-analysis included his fake results as part of its review. When Boldt’s deception became known, and his papers were excluded from the

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of publication bias when we zoom out to look at a whole segment of scientific literature. This zooming-out often takes the form of a meta-analysis, which by combining results from multiple studies can calculate the overall effect (sometimes, perhaps tempting fate, called the ‘true’ effect) on a given topic.

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random fluctuations caused by error should cancel out across different samples – the overall effect size calculated in a meta-analysis is normally considered more reliable than the estimates from individual studies. A meta-analysis doesn’t calculate the overall effect simply by averaging the effect sizes reported by all the included studies. It

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more limited snapshots and are more affected by sampling error, will have more variability, over- and under-estimating the true effect by wider margins. A meta-analysis therefore gives more weight to the effect sizes from big studies, because they’re likely to be more accurate.28 In the context of publication

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one dot per study, you’d expect your graph to look something like Figure 2A below. (Note that this is an idealised version of a meta-analysis; real datasets almost never look this clear-cut.) Looking at this ‘funnel plot’ (so named for what are hopefully obvious reasons), you can see

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funnel shape is just what we’d expect if all the studies had converged upon a real effect. Figure 2. Funnel plots from an imaginary meta-analysis, in two different scenarios. In scenario A, the distribution of the thirty studies is about what you’d expect if every study ever done

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The vertical line in the middle of each graph is the overall effect size calculated by each meta-analysis. In the case of scenario B, it’s been shifted to the right, meaning that the meta-analysis is coming up with a bigger effect than it should. Just as in an archaeological dig,

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a lack of weapons might mean they were civilians rather than soldiers – we can learn a lot from what we don’t see in a meta-analysis. What if our plot looks more like Figure 2B? Here, we’ve lost a chunk from the expected shape. The studies we’d expect

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that fits our pre-existing beliefs and desires), is what’s at the root of publication bias. If you consider the overall conclusions of a meta-analysis based on Figure 2B rather than 2A, you can see how publication bias deranges the scientific literature. If the studies with small effects have

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been removed from the funnel shape, the overall effect that shows up in the meta-analysis will by definition be larger than is justified. We get an exaggerated view of the importance of the effects and can be misled into believing

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or ambiguous studies, researchers force blinkers onto anyone who reads the scientific literature. One of the most striking recent funnel plots was featured in a meta-analysis by the psychologist David Shanks and his colleagues.29 It examined yet another variation on the priming theme: ‘romantic priming’. This is the idea that

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consumption’ to attract partners). Fifteen published papers, documenting forty-three separate experiments, seemed to support this hypothesis. However, when those studies were plotted for the meta-analysis, the funnel had a huge chunk missing: compelling evidence that many of the studies that hadn’t found the effect had been nixed prior to

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have weird shapes for reasons other than publication bias, especially if there are a lot of differences between the assorted studies that go into the meta-analysis.36 There are many cases where publication bias is more subtle, and thus harder to discern, than in those described above. Are there better

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analyses we covered earlier. Even leaving aside the fact that some research is often missing due to publication bias, if the studies included in the meta-analysis are all themselves exaggerated by p-hacking, the overall combined effect – in what’s supposed to be an authoritative overview of all the knowledge on

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powerful forces that affect individuals and shape society. The evidence for the phenomenon is quite weak, and possibly subject to publication bias, for a 2015 meta-analysis reviewing all the relevant stereotype threat studies found a clear gap where the small, null studies on the subject – those that showed girls were equally

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idea that there’s a single ‘quick fix’ for anything as complex as a child’s education.38 To be charitable to Dweck, the meta-analysis came over a decade after the publication of Mindset in 2006. Perhaps it was unclear then how things would turn out for the findings (though

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more unsaturated ones. This is a cornerstone of nutritional advice, repeated in countless dietary guidelines.95 But it didn’t hold up in a 2017 meta-analysis that compared saturated fatty acids to polyunsaturated fatty acids for their effects on heart disease and death.96 This was probably for three reasons. First

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Third, many trials were designed incompetently, with changes in factors other than the diets that could have affected their results.99 The conclusion of the meta-analysis was that there was little compelling evidence for the benefits of replacing saturated with unsaturated fat, and that previous meta-analyses – the ones on which

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so. The first thing to do is to search to see if there are any published replications.6 There might also be a review or meta-analysis of the main result, or of similar results, that can tell you if this study is just an outlier, and also whether its result

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). Of course, reviews and meta-analyses can themselves be corrupted by poor research and publication bias in their source material; if you find a meta-analysis of studies that were all themselves pre-registered, then you’ve hit the jackpot, but I don’t think I’ve ever encountered such a

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31 July 2018; https://www.the-scientist.com/features/replication-failures-highlight-biases-in-ecology-and-evolution-science-64475. Sparrows: Alfredo Sánchez-Tójar et al., ‘Meta-analysis challenges a textbook example of status signalling and demonstrates publication bias’, eLife 7 (13 Nov. 2008): e37385; https://doi.org/10.7554/eLife.37385.001

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-version-of-report-suggests-fujii-will-take-retraction-record-with-172/ 92.  Daniele Fanelli, ‘How Many Scientists Fabricate and Falsify Research? A Systematic Review and Meta-Analysis of Survey Data’, PLOS ONE 4, no. 5 (29 May 2009): e5738; https://doi.org/10.1371/journal.pone.0005738 93.  Ibid. 94.  Gross, ‘

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Zarychanski et al., ‘Association of Hydroxyethyl Starch Administration With Mortality and Acute Kidney Injury in Critically Ill Patients Requiring Volume Resuscitation: A Systematic Review and Meta-Analysis’, JAMA 309, no. 7 (20 Feb. 2013): pp. 678–88; https://doi.org/10.1001/jama.2013.430 122.  And yet, even after 100

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that children with autism spectrum disorder have higher levels of some gastrointestinal symptoms (B. O. McElhanon et al., ‘Gastrointestinal Symptoms in Autism Spectrum Disorder: A Meta-Analysis’, Pediatrics 133, no. 5 (1 May 2014): pp. 872–83; https://doi.org/10.1542/peds.2013-3995), but there’s no evidence that

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, dir. (Twenty Twenty Television, 2004); https://youtu.be/7UbL8opM6TM 126.  Luke E. Taylor et al., ‘Vaccines Are Not Associated with Autism: An Evidence-Based Meta-Analysis of Case-Control and Cohort Studies’, Vaccine 32, no. 29 (June 2014): pp. 3623–29; https://doi.org/10.1016/j.vaccine.2014.04.085

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ed. (London: Weidenfeld & Nicolson, 2016). 26.  The impact a vaccine has on reducing mortality from a disease was the subject of the first ever medical meta-analysis, carried out by the statistician Karl Pearson in 1904 (the disease being typhoid) – though the technique hadn’t yet been named

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2288 (5 Nov. 1904): pp. 1243–46; https://doi.org/10.1136/bmj.2.2288.1243. A useful history and summary of meta-analysis is provided in: Jessica Gurevitch et al., ‘Meta-Analysis and the Science of Research Synthesis’, Nature 555, no. 7695 (Mar. 2018): pp. 175–82; https://doi.org/10.1038/nature25753

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. Climate change: A. J. Challinor et al., ‘A Meta-Analysis of Crop Yield under Climate Change and Adaptation’, Nature Climate Change 4, no. 4 (April 2014): pp. 287–91; https://doi.org/10.1038/nclimate2153

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58; https://doi.org/10.1037/xge0000116. For another example, this time from priming research, with similar results, see Paul Lodder et al., ‘A Comprehensive Meta-Analysis of Money Priming’, Journal of Experimental Psychology: General 148, no. 4 (April 2019): pp. 688–712; https://doi.org/10.1037/xge0000570 30.  Panayiotis A

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of Medicine 358, no. 3 (17 Jan. 2008): pp. 252–60; https://doi.org/10.1056/NEJMsa065779. At the time of writing, the most recent meta-analysis of antidepressants does show a (modest) effect on depression symptoms: Andrea Cipriani et al., ‘Comparative Efficacy and Acceptability of 21 Antidepressant Drugs for the Acute

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Treatment of Adults with Major Depressive Disorder: A Systematic Review and Network Meta-Analysis’, Lancet 391, no. 10128 (April 2018): pp. 1357–66; https://doi.org/10.1016/S0140-6736(17)32802-7 33.  Akira Onishi & Toshi A.

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pp. 931–37; https://doi.org/10.1093/annonc/mdw691 35.  There’s a whole set of techniques to adjust the effect size in your meta-analysis when you discover that there’s publication bias. Since these are guesswork (about how much you should reduce the effect size) stacked on guesswork (

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and Wastes Billions (New York: Basic Books, 2017). 84.  This has been called the ‘Garbage In, Garbage Out’ principle in meta-analysis. Morton Hunt, How Science Takes Stock: The Story of Meta-Analysis (New York: Russell Sage Foundation, 1998). 85.  The absolute number of industry-funded trials has increased over time, although their proportion

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/is-stereotype-threat-overcooked-overstated-and-oversold 101.  Paulette C. Flore & Jelte M. Wicherts, ‘Does Stereotype Threat Influence Performance of Girls in Stereotyped Domains? A Meta-Analysis’, Journal of School Psychology 53, no. 1 (Feb. 2015): pp. 25–44; https://doi.org/10.1016/j. jsp.2014.10.002 and Paulette

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in stereotype threat studies, see Oren R. Shewach et al., ‘Stereotype Threat Effects in Settings with Features Likely versus Unlikely in Operational Test Settings: A Meta-Analysis’, Journal of Applied Psychology 104, no. 12 (Dec. 2019): pp. 1514–34; https://doi.org/10.1037/apl0000420 102.  Subsequently, the same authors ran

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://doi.org/10.3389/978-2-88945-434-1 104.  Jill B. Becker et al, ‘Female Rats Are Not More Variable than Male Rats: A Meta-Analysis of Neuroscience Studies’, Biology of Sex Differences 7, no. 1 (Dec. 2016): 34; https://doi.org/10.1186/s13293-016-0087-5 105.  International

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there have been a great many reliable twin studies since the time of Cyril Burt. For a review, see Tinca J. C. Polderman et al., ‘Meta-Analysis of the Heritability of Human Traits Based on Fifty Years of Twin Studies’, Nature Genetics 47, no. 7 (July 2015): 702–9; https://doi.

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2003): pp. 1141–42; https://doi.org/10.1038/nn1146 55.  Marcus R. Munafò et al., ‘Serotonin Transporter (5-HTTLPR) Genotype and Amygdala Activation: A Meta-Analysis’, Biological Psychiatry 63, no. 9 (May 2008): pp. 852–57; https://doi.org/10.1016/j.biopsych.2007.08.016 56.  Nowadays you can send

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/ 62.  For example, low power is mentioned in the Abstract of: H. Clarke et al., ‘Association of the 5-HTTLPR Genotype and Unipolar Depression: A Meta-Analysis’, Psychological Medicine 40, no. 11 (Nov. 2010): pp. 1767–78; https://doi.org/10.1017/S0033291710000516. Incidentally, you can bet that there was a

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average of the controls. If there was no effect, the probability of this would be 50 per cent (the averages are identical). In the meta-analysis, the mindset effect meant that those who’d been trained to have a growth mindset had a 52.3 per cent chance of being higher

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than the average of the control group. Calculated using https://rpsychologist.com/d3/cohend/ 36.  In the meta-analysis, there was some evidence that particularly at-risk children (those from poorer backgrounds, for example) might benefit more from mindset interventions. This was also

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the case in a recent large-scale study by proponents of growth mindsets, which found similar results to the meta-analysis in general. David S. Yeager et al., ‘A National Experiment Reveals Where a Growth Mindset Improves Achievement’, Nature 573, no. 7774 (Sept. 2019): pp.

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/books/why-we-sleep/ 51.  Xiaoli Shen et al., ‘Nighttime Sleep Duration, 24-Hour Sleep Duration and Risk of All-Cause Mortality among Adults: A Meta-Analysis of Prospective Cohort Studies’, Scientific Reports 6, no. 1 (Feb. 2016): p. 21480; https://doi.org/10.1038/srep21480 52.  Yuheng Chen et al. (

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2018), ‘Sleep Duration and the Risk of Cancer: A Systematic Review and Meta-Analysis Including Dose–Response Relationship’, BMC Cancer 18, no. 1 (Dec. 2018): p. 1149; https://doi.org/10.1186/s12885-018-5025-y 53.  Andrew Gelman

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. nih.gov/pubmed/13592638 75.  Wenjia Hui et al., ‘Fecal Microbiota Transplantation for Treatment of Recurrent C. Difficile Infection: An Updated Randomized Controlled Trial Meta-Analysis’, PLOS ONE 14, no. 1 (2019): e0210016; https://doi.org/10.1371/journal.pone.0210016; Theodore Rokkas et al., ‘A Network

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/in-depth/fat/art-20045550 96.  Steven Hamley, ‘The Effect of Replacing Saturated Fat with Mostly N-6 Polyunsaturated Fat on Coronary Heart Disease: A Meta-Analysis of Randomised Controlled Trials’, Nutrition Journal 16, no. 1 (Dec. 2017): p. 30; https://doi.org/10.1186/s12937-017-0254-5 97.  Also,

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, that are more conservative and thus come up with lower numbers. 38.  Bram Duyx et al., ‘Scientific Citations Favor Positive Results: A Systematic Review and Meta-Analysis’, Journal of Clinical Epidemiology 88 (Aug. 2017): pp. 92–101; https://doi.org/10.1016/j.jclinepi.2017.06.002; see also R. Leimu

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.org/10.1093/ije/dyw314. For an historical example of triangulation, see George Davey Smith, ‘Smoking and Lung Cancer: Causality, Cornfield and an Early Observational Meta-Analysis’, International Journal of Epidemiology 38, no. 5 (1 Oct. 2009): pp. 1169–71; https://doi.org/10.1093/ije/dyp317. Again, though, if we

Artificial Intelligence: A Modern Approach

by Stuart Russell and Peter Norvig  · 14 Jul 2019  · 2,466pp  · 668,761 words

(Liu et al., 2017; Esteva et al., 2017), ophthalmic disease (Gulshan et al., 2016), and skin diseases (Liu et al., 2019c). A systematic review and meta-analysis (Liu et al., 2019a) found that the performance of AI programs, on average, was equivalent to health care professionals. One current emphasis in medical AI

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., and Denniston, A. K. (2019a). A comparison of deep learning performance against health-care professionals in detecting diseases from medical imaging: A systematic review and meta-analysis. The Lancet Digital Health. Liu, Y., Ott, M., Goyal, N., Du, J., Joshi, M., Chen, D., Levy, O., Lewis, M., Zettlemoyer, L., and Stoyanov, V

Theory and Practice of Group Psychotherapy

by Irvin D. Yalom and Molyn Leszcz  · 1 Jan 1967

Practice 2 (1998): 101–117. M. Smith, G. Glass, and T. Miller, The Benefits of Psychotherapy (Baltimore: Johns Hopkins University Press, 1980). L. Tillitski, “A Meta-Analysis of Estimated Effect Sizes for Group Versus Individual Versus Control Treatments,” International Journal of Group Psychotherapy 40 (1990): 215–24. G. Burlingame, K. MacKenzie, and

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,” Group Dynamics: Theory, Research, and Practice 2 (1998): 101–17. W. McDermut, I. Miller, and R. Brown, “The Efficacy of Group Psychotherapy for Depression: A Meta-Analysis and Review of Empirical Research,” Clinical Psychology: Science and Practice 8 (2001): 98–116. G. Burlingame, K. MacKenzie, and B. Strauss, “Small-Group Treatment: Evidence

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. Kaul, “Experiential Group Research: Can the Canon Fire?” in Garfield and Bergin, Handbook of Psychotherapy and Behavioral Change, 4th ed., 631–63. C. Tillitski, “A Meta-Analysis of Estimated Effect Sizes for Group Versus Individual Versus Control Treatments,” International Journal of Group Psychotherapy 40 (1990): 215–24. R. Toseland and M. Siporin

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,” Journal of Consulting and Clinical Psychology 56 (1988): 448–51. 7 A. Horvath and B. Symonds, “Relation Between Working Alliance and Outcome in Psychotherapy: A Meta-Analysis,” Journal of Consulting Psychology 38 (1991): 139–49. F. Fiedler, “A Comparison of Therapeutic Relationships in Psychoanalytic, Non-directive, and Adlerian Therapy,” Journal of Consulting

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, 1994). 22 I. Yalom, “A Study of Group Therapy Dropouts,” Archives of General Psychiatry 14 (1966): 393–414. 23 M. Wierzbicki and G. Pekarik, “A Meta-Analysis of Psychotherapy Dropouts,” Professional Psychology: Research and Practice 24 (1993): 190–95. 24 W. Stone and J. Rutan, “Duration of Treatment in Group Psychotherapy,” International

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Therapy: A Viable Model,” Group 16 (1992): 5–17. 42 W. McDermut, I. Miller, and R. Brown, “The Efficacy of Group Psychotherapy for Depression: A Meta-Analysis and a Review of Empirical Research,” Clinical Psychology: Science and Practice 8 (2001): 98–104. 43 MacKenzie and Grabovac, “Interpersonal Psychotherapy Group.” A. Ravindran et

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of Caring Sciences (Special Issue: The Challenging Complexity of Cancer Care Research) 16 (2002): 224–31. S. Barlow, G. Burlingame, R. Nebeker, and E. Anderson, “Meta-Analysis of Medical Self-Help Groups,” International Journal of Group Psychotherapy 50 (2000): 53–69. 84 Riessman and Banks, “A Marriage of Opposites.” Davison et al

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(2004): 177–92. 89 Davison et al., “Who Talks?” 90 Kelly, “Self-Help for Substance-Use Disorders.” 91 J. Tonigan, R. Toscova, and W. Miller, “Meta-Analysis of the Literature on Alcoholics Anonymous: Sample and Study Characteristics Moderate Findings,” Journal of Studies on Alcohol 57 (1996): 65–72. 92 M. Lieberman and

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(rather than matching or nonrandom assignment), which clearly specified the independent variables employed, and which measured dependent variables by one or more standardized instruments. t Meta-analysis is a statistical approach that examines a large number of scientific studies by pooling their data together into one large data set to determine findings

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, see my story “Travels with Paula” in Momma and the Meaning of Life (New York: HarperCollins, 1999, 15–53). ak The authors of a large meta-analysis concluded that although problems with addictions respond well to self-help groups, clients with medical problems in such groups do not demonstrate objective benefits commensurate

How to Read a Paper: The Basics of Evidence-Based Medicine

by Trisha Greenhalgh  · 18 Nov 2010  · 321pp  · 97,661 words

ratios Clinical prediction rules References Chapter 9: Papers that summarise other papers (systematic reviews and meta-analyses) When is a review systematic? Evaluating systematic reviews Meta-analysis for the non-statistician Explaining heterogeneity New approaches to systematic review References Chapter 10: Papers that tell you what to do (guidelines) The great guidelines

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(see Chapter 7) Checklist for a paper that claims to validate a diagnostic or screening test (see Chapter 8) Checklist for a systematic review or meta-analysis (see Chapter 9) Checklist for a set of clinical guidelines (see Chapter 10) Checklist for an economic analysis (see Chapter 11) Checklist for a

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4. Potentially eradicates bias by comparing two otherwise identical groups (but see subsequent text and section ‘Was systematic bias avoided or minimised?’). 5. Allows for meta-analysis (combining the numerical results of several similar trials) at a later date; see section ‘Ten questions to ask about a paper that claims to validate

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are unnecessary, impractical or inappropriate: RCTs are unnecessary when a clearly successful intervention for an otherwise fatal condition is discovered; when a previous RCT or meta-analysis has given a definitive result (either positive or negative—see section ‘Probability and confidence’). Arguably, it is actually unethical to ask patients to be randomised

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critically appraised according to rigorous criteria (see Chapter 9). Note, however, that not even the most hard-line protagonist of EBM would place a sloppy meta-analysis or an RCT that was seriously methodologically flawed above a large, well-designed cohort study. And as Chapter 12 shows, many important and valid studies

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Lancet 1907;1:1776. 9 Sterne JA, Egger M, Smith GD. Systematic reviews in health care: investigating and dealing with publication and other biases in meta-analysis. BMJ: British Medical Journal 2001;323(7304):101. 10 Cuff A. Sources of Bias in Clinical Trials. 2013. http://applyingcriticality.wordpress.com/2013/06/19

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more rigorous (in particular, does it address any specific methodological criticisms of previous studies)? Will the numerical results of this study add significantly to a meta-analysis of previous studies? Is the population studied different in any way (e.g. has the study looked at different ethnic groups, ages or gender than

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(5):S16–23. 10 Ronksley PE, Brien SE, Turner BJ, et al. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ: British Medical Journal 2011;342:d671. 11 Stockwell T, Greer A, Fillmore K, et al. How good is the science? BMJ: British Medical

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, et al. The effect of combination treatment with aliskiren and blockers of the renin–angiotensin system on hyperkalaemia and acute kidney injury: systematic review and meta-analysis. BMJ: British Medical Journal 2012;344:e42. 17 Bero L. Industry sponsorship and research outcome: a Cochrane review. JAMA Internal Medicine 2013;173(7):

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disadvantaged children [5]. In 19 studies, all of which had tested this complex intervention in a randomised controlled trial (see the linked Cochrane review and meta-analysis [6]), I found a total of six different mechanisms by this intervention may have improved nutritional status, school performance or both: long-term correction of

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of other-language studies is not, generally, associated with biased results (it's just bad science) [10]. Furthermore, particularly where a statistical synthesis of results (meta-analysis) is contemplated, it may be necessary to write and ask the authors of the primary studies for data that were not originally included in the

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published review (see section ‘Meta-analysis for the non-statistician’). Even when all this has been done, the systematic reviewer's search for material has hardly begun. As Knipschild and colleagues

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. Overall, the ‘trials’ showed no significant benefit from the three therapies. However, the simulation of a number of perfectly plausible events in the process of meta-analysis—such as the exclusion of several of the ‘negative’ trials through publication bias (see section ‘Randomised controlled trials’), a subgroup analysis that excluded data on

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for good physiological reasons. The inclusion in systematic reviews of irrelevant studies is guaranteed to lead to absurdities and reduce the credibility of secondary research. Meta-analysis for the non-statistician If I had to pick one term that exemplifies the fear and loathing felt by so many students, clinicians and consumers

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towards EBM, that word would be ‘meta-analysis’. The meta-analysis, defined as a statistical synthesis of the numerical results of several trials that all addressed the same question, is the statisticians' chance to pull

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control group that received no active treatment and in whom pharmacotherapy (PHA—i.e. drug treatment) was discontinued [14]. The primary (main) outcome in this meta-analysis was relapse within 1 year. Figure 9.2 Forest plot showing long-term effects of cognitive behaviour therapy (CBT) compared with no active treatment and

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the relative merits of this therapy compared to other treatments for depression. The paper from which Figure 9.2 is taken also described a second meta-analysis that showed no significant difference between CBT and continuing antidepressant therapy, suggesting, perhaps, that patients who prefer not to have CBT may do just

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shown by the narrower width of the diamond compared with the individual lines, demonstrates the strength of the evidence in favour of this intervention. This meta-analysis showed that infants of steroid-treated mothers were 30–50% less likely to die than infants of control mothers. This example is discussed further in

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Logo. You may have worked out by now that anyone who is thinking about doing a clinical trial of an intervention should first do a meta-analysis of all the previous trials on that same intervention. In practice, researchers only occasionally do this. Dean Fergusson and colleagues of the Ottawa Health

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Research Institute published a cumulative meta-analysis of all randomised controlled trials carried out on the drug aprotinin in peri-operative bleeding during cardiac surgery [16]. They lined up the trials in

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the research communities. The beneficial effect of aprotinin reached statistical significance after only 12 trials—that is, back in 1992. But because nobody did a meta-analysis at the time, a further 52 clinical trials were undertaken (and more may be ongoing). All these trials were scientifically unnecessary and unethical (because half

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textbook on the topic [18]. Explaining heterogeneity In everyday language, ‘homogeneous’ means ‘of uniform composition’, and ‘heterogeneous’ means ‘many different ingredients’. In the language of meta-analysis, homogeneity means that the results of each individual trial are compatible with the results of any of the others. Homogeneity can be estimated at a

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‘Were preliminary statistical questions addressed?’) to detect small but important levels of heterogeneity.) A χ2 value much greater than the number of trials in a meta-analysis tells us that the trials that contributed to the analysis are different in some important way from one another. There may, for example, be known

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of studies that were performed on different populations in different places at different times and for different reasons. Eysenck's reservations about meta-analysis are borne out in the infamously discredited meta-analysis that demonstrated (wrongly) that there was significant benefit to be had from giving intravenous magnesium to heart attack victims. A subsequent

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terms of publication bias, methodological weaknesses in the smaller trials and clinical heterogeneity [22] [23]. (Incidentally, for more debate on the pros and cons of meta-analysis versus megatrials, see this recent paper [24].) Eysenck's mathematical naiveté is embarrassing (‘if a medical treatment has an effect so recondite and obscure as

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, Hollon SD, van Straten A, et al. Does cognitive behaviour therapy have an enduring effect that is superior to keeping patients on continuation pharmacotherapy? A meta-analysis. BMJ Open 2013;3(4) doi: 10.1136/bmjopen-2012-002542[published Online First: Epub Date]. 15 Egger M, Smith GD, Altman D. Systematic

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reviews in health care: meta-analysis in context. Chichester: Wiley.com, 2008. 16 Fergusson D, Glass KC, Hutton B, et al. Randomized controlled trials of aprotinin in cardiac surgery: could clinical

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reviews using individual patient data. Evaluation & the Health Professions 2002;25(1):76–97. 18 Borenstein M, Hedges LV, Higgins JP, et al. Introduction to meta-analysis. Chichester: Wiley.com, 2011. 19 Thompson SG. Why and how sources of heterogeneity should be investigated. In: Egger M, Davey Smith G, Altman DG,

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eds. Systematic reviews in health care: meta-analysis in context. London: BMJ Publications, 2001;157–175. 20 Greenhalgh T. Outside the box: why are Cochrane reviews so boring? The British Journal of General

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Practice 2012;62(600):371;157–175. 21 Eysenck H. Problems with meta-analysis. In: Chalmers I, Altman DG, eds. Systematic reviews. London: BMJ Publications, 1995. 22 Higgins JP, Spiegelhalter DJ. Being sceptical about meta-analyses: a Bayesian

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perspective on magnesium trials in myocardial infarction. International Journal of Epidemiology 2002;31(1):96–104. 23 Egger M, Smith GD. Misleading meta-analysis. BMJ: British Medical Journal 1995;311(7007):753–4. 24 Hennekens CH, DeMets D. The need for large-scale randomized evidence without undue emphasis on

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: The Journal of the American Medical Association 2009;302(21):2361–2. 25 Griffin S, Greenhalgh T. Diabetes care in general practice: meta-analysis of randomised control trials Commentary: meta-analysis is a blunt and potentially misleading instrument for analysing models of service delivery. BMJ: British Medical Journal 1998;317(7155):390–6. 26

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Greenhalgh T. Commentary: meta-analysis is a blunt and potentially misleading instrument for analysing models of service delivery. BMJ: British Medical Journal (Clinical research ed.) 1998;317(7155):395–6

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have been pulled together (that is, synthesised) in the context of the clinical and policy needs being addressed. For one thing, a systematic review and meta-analysis might have been appropriate, and if the latter, issues of probability and confidence should have been dealt with acceptably (see section ‘Summing up’). But systematic

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or it may not. Sensitivity analysis, or exploration of ‘what-ifs’, was described in section ‘Validating diagnostic tests against a gold standard’ in relation to meta-analysis. Exactly the same principles apply here: if adjusting the figures to account for the full range of possible influences gives you a totally different answer

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quality improvement studies are often small, local and even somewhat parochial, critically appraising such studies is often more of a headache than appraising a large meta-analysis! References 1 Batalden PB, Davidoff F. What is “quality improvement” and how can it transform healthcare? Quality and Safety in Health Care 2007;16(

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not until the mid-1980s that an effective product was developed. By the late 1980s, a number of randomised trials had taken place, and a meta-analysis published in 1990 suggested that the benefits of artificial surfactant greatly outweighed its risks. In 1990, a 6000-patient trial (OSIRIS) was begun, involving

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fetal maturation on perinatal outcomes. JAMA: The Journal of the American Medical Association 1995;273(5):413–8. 3 Crowley PA. Antenatal corticosteroid therapy: a meta-analysis of the randomized trials, 1972 to 1994. American Journal of Obstetrics and Gynecology 1995;173(1):322–35. 4 Halliday H. Overview of clinical trials

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F, Grimshaw J, et al. Printed educational materials: effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews 2012;10. 22 Hysong SJ. Meta-analysis: audit and feedback features impact effectiveness on care quality. Medical Care 2009;47(3):356–63. 23 Flodgren G, Eccles MP, Shepperd S, et al

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based’ assumption was that the more intensively a person's blood glucose was controlled, the better the outcomes would be. But more recently, a large meta-analysis showed that intensive glucose control had no benefit over moderate control, but was associated with a twofold increase in the incidence of severe hypoglycaemia [13

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still being performance-managed through a scheme called the Quality and Outcomes Framework (QOF) to strive for intensive glucose control after the publication of that meta-analysis had shown an adverse benefit–harm ratio [14]. This is because it takes time for practice and policy to catch up with the evidence –

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T, Saadatian-Elahi M, et al. Effect of intensive glucose lowering treatment on all cause mortality, cardiovascular death, and microvascular events in type 2 diabetes: meta-analysis of randomised controlled trials. BMJ: British Medical Journal 2011;343:d4169. 14 Calvert M, Shankar A, McManus RJ, et al. Effect of the quality and

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, other controlled clinical trial, cohort study, case–control study, cross-sectional survey, longitudinal survey, case report, or case series)? Secondary research (simple overview, systematic review, meta-analysis, decision analysis, guideline development, economic analysis)? 3. Was the study design appropriate to the broad field of research addressed (therapy, diagnosis, screening, prognosis, causation)? 4

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clinical question that reflects a problem of relevance to patients? Do they provide evidence on safety, tolerability, efficacy and price? 5. Has each trial or meta-analysis defined the condition to be treated, the patients to be included, the interventions to be compared and the outcomes to be examined? 6. Does the

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. Has this test been placed in the context of other potential tests in the diagnostic sequence for the condition? Checklist for a systematic review or meta-analysis (see Chapter 9) 1. Did the review address an important clinical question? 2. Was a thorough search carried out of the appropriate database(s)

Trick or Treatment: The Undeniable Facts About Alternative Medicine

by Edzard Ernst and Simon Singh  · 17 Aug 2008  · 357pp  · 110,072 words

of research into homeopathy in order to develop an over-arching conclusion that took into consideration each and every trial. This is known as a meta-analysis, which means an analysis of various analyses. In other words, each individual trial into homeopathy concluded with an analysis of its own data, and Linde

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was proposing to pool all these separate analyses in order to generate a new, more reliable, overall result. Meta-analysis can be considered as a particular type of systematic review, a concept that was introduced in the previous chapter. Like a systematic review, a

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meta-analysis attempts to draw an overall conclusion from several separate trials, except that a meta-analysis tends to involve a more mathematical approach. Although the term meta-analysis might be unfamiliar to many readers, it is a concept that crops up in

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single poll, because the meta-poll (i.e. poll of polls) reflects the complete data from a much larger group of voters. The power of meta-analysis becomes obvious if we examine some hypothetical sets of data concerning astrology. If your astrological sign determined your character, then an astrologer should be able

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one way to interpret these sets of data would be to conclude that, in general, the experiments support astrology. However, a meta-analysis would come to a different conclusion. The meta-analysis would start by pointing out that the number of attempts made by the astrologer in any one of the experiments was relatively

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could be explained by mere chance. In other words, the result of any one of these experiments is effectively meaningless. Next, the researcher doing the meta-analysis would combine all the data from the individual experiments as though they were part of one giant experiment. This tells us that the astrologer had

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.98 out of 12, which is very close to 1 out of 12, the hit rate expected by chance alone. The conclusion of this hypothetical meta-analysis would be that the astrologer has demonstrated no special ability to determine a person’s star sign based on their personality. This conclusion is far

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more reliable than anything that could have been deduced solely from any one of the small-scale experiments. In scientific terms: a meta-analysis is said to minimize random and selection biases. Turning to medical research, there are numerous treatments that have been tested by

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meta-analysis. For example, in the 1980s researchers wanted to know if corticosteroid medication could help reduce respiratory problems in premature babies. They designed a trial which

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each individual trial varied from hospital to hospital, because the numbers of babies in each trial was small and random influences were large. Yet a meta-analysis of all the trials showed with certainty that corticosteroid medication during pregnancy benefited premature babies. This treatment is part of the reason why the number

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syndrome has fallen dramatically – there were 25,000 such deaths in America in the early 1950s and today the number is fewer than 500. The meta-analysis in the premature baby study was fairly straightforward, because the individual trials were similar to each other and so they could be merged easily. The

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same is true of the hypothetical example concerning astrology. Unfortunately, conducting a meta-analysis is often a messy business, because the individual trials have generally been conducted in different ways. Trials for the same medication might vary according to

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the dose given, the period of monitoring, and so on. In Linde’s case, the meta-analysis was particularly problematic. In order to draw a conclusion about the efficacy of homeopathy, Linde was attempting to include homeopathy trials investigating a huge variety

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homeopathic conferences, contacted researchers in the field and eventually found 186 published trials on homeopathy. He and his colleagues then decided to exclude from his meta-analysis those trials that failed to meet certain basic conditions. For example, in addition to a group of patients being treated with homeopathy and a control

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weight in the overall conclusion, because the reliability of a trial’s result is closely linked to the number of participants in the trial. The meta-analysis was eventually published in September 1997 in the Lancet. It was one of the most controversial medical research papers of the year, because its conclusion

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were much more likely to show signs of improvement than those patients in the control groups receiving placebo. The paper concluded: ‘The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo.’ In other words, according to the

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meta-analysis, homeopathy was genuinely effective. Not surprisingly, Linde’s conclusion was questioned by opponents of homeopathy. Critics argued that his meta-analysis had been too lax, inasmuch as it had included too many trials of relatively poor quality

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is a good indication of their overall level of rigour. Critics pointed out that sixty-eight out of the eighty-nine trials in Linde’s meta-analysis scored only 3 or less on the Oxford scale, which meant that three-quarters of the trials were substandard. Moreover, critics pointed out that restricting

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the meta-analysis to the higher-quality trials (4 or 5 points) drastically reduced the apparent efficacy of homeopathy. In fact, the conclusion of the twenty-one higher

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was clear evidence that studies with better methodological quality tended to yield less positive results.’ Then, referring back to the original meta-analysis, he stressed: ‘It seems, therefore, likely that our meta-analysis at least over-estimated the effects of homeopathic treatments.’ Linde’s original 1997 paper had supported homeopathy, yet his revised 1999

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paper was much more equivocal. His re-analysis of his own meta-analysis obviously disappointed the alternative medicine community, yet it was also frustrating for the medical establishment. Everyone was dissatisfied because Linde was neither able to claim

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scrutiny from the late 1990s onwards. This eventually prompted Dr Aijing Shang and his colleagues at the University of Berne, Switzerland, to undertake a fresh meta-analysis of all the trials published up to January 2003. The medical research group at Berne, which is led by Professor Mathias Eggers, has a world

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-wide reputation for excellence and the Swiss government had provided the team with adequate funding for a fully rigorous meta-analysis. Hopes were high that Shang would at last be able to deliver a reliable conclusion. Indeed, after two centuries of bitter dispute between homeopaths and

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mainstream medics, Shang’s meta-analysis was destined to decide, at last, who was right and who was wrong. Shang was ruthless in his demand for quality, which meant that his

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meta-analysis included only those trials with large numbers of participants, decent blinding and proper randomization. In the end, he was left with only eight homeopathy trials.

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After studying the data from these eight trials – the best available trials on homeopathy – his meta-analysis reached its momentous conclusion. On average, homeopathy was only very marginally more effective than placebo. So, did this tiny marginal average benefit suggest that homeopathy

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his conclusion was wholly compatible with the judgement that homeopathy acted as nothing more than a placebo. In fact, the most sensible interpretation of the meta-analysis was that homeopathy was indeed nothing more than a placebo. This interpretation becomes more convincing if we bear in mind another aspect of his research

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. While conducting his meta-analysis on homeopathy, he also conducted a meta-analysis for a whole variety of new, conventional pharmaceuticals. These pharmaceuticals had been tested on the same illnesses that had been considered for

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the homeopathy meta-analysis. In this secondary meta-analysis, Shang scrupulously applied exactly the same selection criteria to these conventional drug trials as he had done in his homeopathy meta-analysis. The

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result of his meta-analysis on conventional drug trials was that on average they worked. Although

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body. This illustrates the stark difference between pseudo-medicine and real medicine. Shang published his results in the Lancet in August 2005. Based on his meta-analysis, he concluded: ‘This finding is compatible with the notion that the clinical effects of homeopathy are placebo effects.’ Reinforcing this point, the Lancet ran an

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about homeopathy’s lack of benefit’. This sparked major news stories around the world, angering homeopaths who refused to accept the conclusions of Shang’s meta-analysis and the Lancet’s accompanying statement. They attempted to undermine the research by pointing out four key issues, but in fact each of their criticisms

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can be easily addressed. Homeopaths might argue that Shang’s paper indicates a positive effect for homeopathy, and that his meta-analysis therefore supports homeopathy. There is indeed a positive effect for homeopathy, but it is very small and entirely compatible with the treatment being a placebo

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offers any benefit beyond placebo. Homeopaths claim that Shang dredged the data, which means that the meta-analysis was conducted in such a way as to bias the conclusion. There are indeed many ways to conduct a meta-analysis. Therefore it is possible to ‘dredge the data’ in different ways until the most positive

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or negative result emerges, but importantly Shang had stated what his approach would be before embarking on the meta-analysis, and his approach seemed reasonable and unbiased. In other words, the research was impartial because the goalposts were decided before the data was examined, and

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the goalposts were of a fair size and were not moved once the research was under way. Homeopaths point out that the meta-analysis included trials for several illnesses, which makes it too crude to say anything meaningful about homeopathy’s ability to treat individual conditions. This over-arching

…

meta-analysis was prompted by the fact that there has been no convincing evidence that homeopathy can treat any individual condition. Whenever researchers have conducted systematic reviews

…

and over again there were tantalizing indications that St John’s wort was more than a mere placebo. The next step was to perform a meta-analysis, whereby all the data from all the trials would be carefully brought together in order to get a firmer grasp of the true value of

…

the plant. The first meta-analysis of St John’s wort was conducted in 1996 and included the results from twenty-three studies. Referring to St John’s wort by its

…

of publicity, sales of St John’s wort in America increased by a factor of 30 in just three years. The conclusion of the 1996 meta-analysis was reinforced in 2005 by the Cochrane Collaboration. It conducted a systematic review entitled St John’s wort for depression, which covered all the thirty

…

constant field strength rather than fluctuating strength – magnets relates to pain control. Researchers at Exeter University recently included nine placebo-controlled, randomized trials in a meta-analysis. The results do not support the use of static magnets for pain relief. For other problems, such as menstrual symptoms or varicose veins, the evidence

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Flow: The Psychology of Optimal Experience

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The Social Animal: The Hidden Sources of Love, Character, and Achievement

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The Narcissist Next Door

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Copenhagenize: The Definitive Guide to Global Bicycle Urbanism

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The Complacent Class: The Self-Defeating Quest for the American Dream

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The End of My Addiction

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Twilight of the Elites: America After Meritocracy

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The Human Cosmos: A Secret History of the Stars

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The Digital Divide: Arguments for and Against Facebook, Google, Texting, and the Age of Social Netwo Rking

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How to Do the Work: Recognize Your Patterns, Heal From Your Past, and Create Your Self

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The Heart of Business: Leadership Principles for the Next Era of Capitalism

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Neurodiversity at Work: Drive Innovation, Performance and Productivity With a Neurodiverse Workforce

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The Next Great Migration: The Beauty and Terror of Life on the Move

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The Broken Ladder

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A Life Less Throwaway: The Lost Art of Buying for Life

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Break Through: Why We Can't Leave Saving the Planet to Environmentalists

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Rough Sleepers: Dr. Jim O'Connell's Urgent Mission to Bring Healing to Homeless People

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Critical: Science and Stories From the Brink of Human Life

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The Aristocracy of Talent: How Meritocracy Made the Modern World

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The Matter of the Heart: A History of the Heart in Eleven Operations

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Survival of the Friendliest: Understanding Our Origins and Rediscovering Our Common Humanity

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Alone Together

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21 Lessons for the 21st Century

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Why We Get Fat and What to Do About It

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Sex, Lies, and Pharmaceuticals: How Drug Companies Plan to Profit From Female Sexual Dysfunction

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The Rational Optimist: How Prosperity Evolves

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Overwhelmed: Work, Love, and Play When No One Has the Time

by Brigid Schulte  · 11 Mar 2014  · 455pp  · 133,719 words

Duped: Double Lives, False Identities, and the Con Man I Almost Married

by Abby Ellin  · 15 Jan 2019  · 340pp  · 91,745 words

American Girls: Social Media and the Secret Lives of Teenagers

by Nancy Jo Sales  · 23 Feb 2016  · 487pp  · 147,238 words

Everyday Utopia: What 2,000 Years of Wild Experiments Can Teach Us About the Good Life

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Uncomfortably Off: Why the Top 10% of Earners Should Care About Inequality

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The Genius Within: Unlocking Your Brain's Potential

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Wasteland: The Dirty Truth About What We Throw Away, Where It Goes, and Why It Matters

by Oliver Franklin-Wallis  · 21 Jun 2023  · 309pp  · 121,279 words

Moral Ambition: Stop Wasting Your Talent and Start Making a Difference

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Reimagining Capitalism in a World on Fire

by Rebecca Henderson  · 27 Apr 2020  · 330pp  · 99,044 words

The Willpower Instinct: How Self-Control Works, Why It Matters, and What You Can Doto Get More of It

by Kelly McGonigal  · 1 Dec 2011  · 354pp  · 91,875 words

Never Enough: The Neuroscience and Experience of Addiction

by Judith Grisel  · 15 Feb 2019  · 213pp  · 68,363 words

Suggestible You: The Curious Science of Your Brain's Ability to Deceive, Transform, and Heal

by Erik Vance  · 14 Sep 2016  · 266pp  · 85,265 words

The Other Side of Happiness: Embracing a More Fearless Approach to Living

by Brock Bastian  · 25 Jan 2018

Dopesick: Dealers, Doctors and the Drug Company That Addicted America

by Beth Macy  · 4 Mar 2019  · 441pp  · 124,798 words

The End of College: Creating the Future of Learning and the University of Everywhere

by Kevin Carey  · 3 Mar 2015  · 319pp  · 90,965 words

Daughter Detox: Recovering From an Unloving Mother and Reclaiming Your Life

by Peg Streep  · 14 May 2017

The Microbiome Solution

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WEconomy: You Can Find Meaning, Make a Living, and Change the World

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Choked: Life and Breath in the Age of Air Pollution

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The Day the World Stops Shopping

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Progress: Ten Reasons to Look Forward to the Future

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Origins: How Earth's History Shaped Human History

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The Buddha and the Badass: The Secret Spiritual Art of Succeeding at Work

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The Measure of Progress: Counting What Really Matters

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Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal

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Every Patient Tells a Story

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The Road to Character

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Alive

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Jaws

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Team Topologies: Organizing Business and Technology Teams for Fast Flow

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Why We Work

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The One-Minute Workout

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The Sleeping Beauties: And Other Stories of Mystery Illness

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Less Is More: How Degrowth Will Save the World

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Hothouse Kids: The Dilemma of the Gifted Child

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Fair Shot: Rethinking Inequality and How We Earn

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Brotopia: Breaking Up the Boys' Club of Silicon Valley

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Braving the Wilderness: The Quest for True Belonging and the Courage to Stand Alone

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Sex Power Money

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The Education of Millionaires: It's Not What You Think and It's Not Too Late

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The Complete Thyroid Book

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Nothing Personal: My Secret Life in the Dating App Inferno

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The 5 Types of Wealth: A Transformative Guide to Design Your Dream Life

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Never Enough: When Achievement Culture Becomes Toxic-And What We Can Do About It

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The Fast Diet: Revised and Updated: Lose Weight, Stay Healthy, Live Longer

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Overcoming Adrenal Fatigue: How to Restore Hormonal Balance and Feel Renewed, Energized, and Stress Free

by Kathryn Simpson  · 1 May 2011  · 158pp  · 46,760 words

The Antidote: Happiness for People Who Can't Stand Positive Thinking

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Adventures in Human Being (Wellcome)

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Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting

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The Future Won't Be Long

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The Great Stagnation

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Trillion Dollar Coach: The Leadership Playbook of Silicon Valley's Bill Campbell

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Animal: The Autobiography of a Female Body

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Spiralizer Cookbook

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A Short Guide to a Long Life

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Fluent Forever: How to Learn Any Language Fast and Never Forget It

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Potatoes not Prozac

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Things That Matter: Overcoming Distraction to Pursue a More Meaningful Life

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