Ain't necessarily so: review and critique of recent meta-analyses of behavioral medicine interventions in health psychology

Health Psychol. 2010 Mar;29(2):107-16. doi: 10.1037/a0017633.

Abstract

Objective: We examined four meta-analyses of behavioral interventions for adults (Dixon, Keefe, Scipio, Perri, & Abernethy, 2007; Hoffman, Papas, Chatkoff, & Kerns, 2007; Irwin, Cole, & Nicassio, 2006; and Jacobsen, Donovan, Vadaparampil, & Small, 2007) that have appeared in the Evidence Based Treatment Reviews section of Health Psychology.

Design: Narrative review.

Main outcome measures: We applied the following criteria to each meta-analysis: (1) whether each meta-analysis was described accurately, adequately, and transparently in the article; (2) whether there was an adequate attempt to deal with methodological quality of the original trials; (3) the extent to which the meta-analysis depended on small, underpowered studies; and (4) the extent to which the meta-analysis provided valid and useful evidence-based recommendations.

Results: Across the four meta-analyses, we identified substantial problems with the transparency and completeness with which these meta-analyses were reported, as well as a dependence on small, underpowered trials of generally poor quality.

Conclusion: Results of our exercise raise questions about the clinical validity and utility of the conclusions of these meta-analyses. Results should serve as a wake up call to prospective authors, reviewers, and end-users of meta-analyses now appearing in the literature.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged, 80 and over
  • Behavioral Medicine / methods
  • Behavioral Medicine / statistics & numerical data*
  • Bias
  • Cognitive Behavioral Therapy / methods
  • Cognitive Behavioral Therapy / standards
  • Evidence-Based Practice*
  • Health Policy
  • Humans
  • Meta-Analysis as Topic*
  • Randomized Controlled Trials as Topic
  • Reproducibility of Results
  • Research Design
  • Sleep Initiation and Maintenance Disorders / psychology
  • Sleep Initiation and Maintenance Disorders / therapy
  • Treatment Outcome