Statistics in medical journals: some recent trends.

I review some areas of medical statistics that have gained prominence over the last 5-10 years: meta-analysis, evidence-based medicine, and cluster randomized trials. I then consider several issues relating to data analysis and interpretation, many relating to the use and misuse of hypothesis testing, drawing on recent reviews of the use of statistics in medical journals. I also consider developments in the reporting of research in medical journals.

[1]  D G Altman,et al.  Confidence intervals for the number needed to treat , 1998, BMJ.

[2]  Moses Le,et al.  MEASURING EFFECTS WITHOUT RANDOMIZED TRIALS ? OPTIONS, PROBLEMS, CHALLENGES , 1995 .

[3]  G Lewis,et al.  Putting trials on trial--the costs and consequences of small trials in depression: a systematic review of methodology. , 1997, Journal of epidemiology and community health.

[4]  Lisa A. Weissfeld,et al.  A study of the effect of dichotomizing ordinal data upon modeling , 1998 .

[5]  D P Byar,et al.  Using observational data from registries to compare treatments: the fallacy of omnimetrics. , 1984, Statistics in medicine.

[6]  I. Olkin,et al.  Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement , 1999, The Lancet.

[7]  J. Simpson,et al.  Accounting for cluster randomization: a review of primary prevention trials, 1990 through 1993. , 1995, American journal of public health.

[8]  David R. Jones,et al.  Systematic reviews of trials and other studies. , 1998, Health technology assessment.

[9]  W. Sauerbrei,et al.  Dangers of using "optimal" cutpoints in the evaluation of prognostic factors. , 1994, Journal of the National Cancer Institute.

[10]  D G Altman,et al.  Statistics in medical journals. , 1982, Statistics in medicine.

[11]  M. Kanter,et al.  Accuracy of statistical methods in TRANSFUSION: a review of articles from July/August 1992 through June 1993 , 1994, Transfusion.

[12]  R. Aster,et al.  Statistics in articles published in TRANSFUSION , 1994, Transfusion.

[13]  G. Smith,et al.  Meta-analysis Spurious precision? Meta-analysis of observational studies , 1998, BMJ.

[14]  David R. Jones,et al.  An introduction to bayesian methods in health technology assessment , 1999, BMJ.

[15]  Sponsored trials do not necessarily give more-favourable results , 1999, BMJ.

[16]  D. Bruns,et al.  Toward a checklist for reporting of studies of diagnostic accuracy of medical tests. , 2000, Clinical chemistry.

[17]  Beyond conflict of interest. Biomedical journals need a concerted response against influence of tobacco industry. , 1999 .

[18]  J J Deeks,et al.  Systematic reviews of published evidence: miracles or minefields? , 1998, Annals of oncology : official journal of the European Society for Medical Oncology.

[19]  T. Perneger.  What's wrong with Bonferroni adjustments , 1998, BMJ.

[20]  D A Katerndahl,et al.  Variability in meta-analytic results concerning the value of cholesterol reduction in coronary heart disease: a meta-meta-analysis. , 1999, American journal of epidemiology.

[21]  B. H. Layne,et al.  Low power, type II errors, and other statistical problems in recent cardiovascular research. , 1997, The American journal of physiology.

[22]  S. Hollis,et al.  What is meant by intention to treat analysis? Survey of published randomised controlled trials , 1999, BMJ.

[23]  A. Carr,et al.  Primary total hip replacement surgery: a systematic review of outcomes and modelling of cost-effectiveness associated with different prostheses. , 1998, Health technology assessment.

[24]  P. Bossuyt,et al.  Empirical evidence of design-related bias in studies of diagnostic tests. , 1999, JAMA.

[25]  D Wartenberg,et al.  Defining exposure in case-control studies: a new approach. , 1991, American journal of epidemiology.

[26]  S J White,et al.  Statistical Errors in Papers in the British Journal of Psychiatry , 1979, British Journal of Psychiatry.

[27]  K J Rothman,et al.  Writing for Epidemiology , 1998, Epidemiology.

[28]  D. Altman.  Suboptimal analysis using 'optimal' cutpoints. , 1998, British Journal of Cancer.

[29]  D Moher,et al.  CONSORT: an evolving tool to help improve the quality of reports of randomized controlled trials. Consolidated Standards of Reporting Trials. , 1998, JAMA.

[30]  M. Egger,et al.  The hazards of scoring the quality of clinical trials for meta-analysis. , 1999, JAMA.

[31]  A D Oxman,et al.  The unpredictability paradox: review of empirical comparisons of randomised and non-randomised clinical trials , 1998, BMJ.

[32]  E. Skovlund,et al.  A critical review of papers from clinical cancer research. , 1998, Acta oncologica.

[33]  Norman E. Breslow,et al.  Biostatistics and Bayes , 1990 .

[34]  Jacob Cohen.  The Cost of Dichotomization , 1983 .

[35]  S. Goodman,et al.  Multiple comparisons, explained. , 1998, American journal of epidemiology.

[36]  D L Sackett,et al.  An assessment of clinically useful measures of the consequences of treatment. , 1988, The New England journal of medicine.

[37]  D. Cook,et al.  Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? , 1998, The Lancet.

[38]  P. Gøtzsche.  Methodology and overt and hidden bias in reports of 196 double-blind trials of nonsteroidal antiinflammatory drugs in rheumatoid arthritis. , 1989, Controlled clinical trials.

[39]  R. J. Hayes,et al.  Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. , 1995, JAMA.

[40]  D G Altman,et al.  Statistics notes: Absence of evidence is not evidence of absence , 1995 .

[41]  D G Altman,et al.  Statistics Notes: Interaction 2: compare effect sizes not P values , 1996, BMJ.

[42]  L. Smeeth,et al.  Numbers needed to treat derived from meta-analyses—sometimes informative, usually misleading , 1999, BMJ.

[43]  J M Bland,et al.  Trials which randomize practices II: sample size. , 1998, Family practice.

[44]  D. Sackett,et al.  70 Choosing an appropriate dichotomous effect measure for meta-analysis: Empirical evidence of the appropriateness of the odds ratio and relative risk , 1997 .

[45]  K J Rothman,et al.  No Adjustments Are Needed for Multiple Comparisons , 1990, Epidemiology.

[46]  G. E. Welch,et al.  Review of statistics usage in the American Journal of Obstetrics and Gynecology. , 1996, American journal of obstetrics and gynecology.

[47]  L A Moyé,et al.  P-value interpretation and alpha allocation in clinical trials. , 1998, Annals of epidemiology.

[48]  D G Altman,et al.  The scandal of poor medical research , 1994, BMJ.

[49]  Richard J Lilford,et al.  Ethical issues in the design and conduct of cluster randomised controlled trials , 1999, BMJ.

[50]  P A Lachenbruch,et al.  Some Misuses of Discriminant Analysis , 1977, Methods of Information in Medicine.

[51]  S Greenland,et al.  Random-effects meta-analyses are not always conservative. , 1999, American journal of epidemiology.

[52]  J M Bland,et al.  Trials which randomize practices I: how should they be analysed? , 1998, Family practice.

[53]  C. Adams,et al.  Content and quality of 2000 controlled trials in schizophrenia over 50 years , 1998, BMJ.

[54]  N. Black.  Why we need observational studies to evaluate the effectiveness of health care , 1996, BMJ.

[55]  G. Andrews,et al.  Meta-analysis of the effects of stuttering treatment. , 1980, The Journal of speech and hearing disorders.

[56]  Jonathan J. Deeks,et al.  Down with odds ratios! , 1996, Evidence Based Medicine.

[57]  N. Black,et al.  The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. , 1998, Journal of epidemiology and community health.

[58]  L. Bouter,et al.  Methodological Quality of Randomized Clinical Trials on Treatment Efficcact in Low Back Pain , 1995, Spine.

[59]  S. Mcguigan.  The use of Statistics in the British Journal of Psychiatry , 1995, British Journal of Psychiatry.

[60]  D A Savitz,et al.  Statistical significance testing in the American Journal of Epidemiology, 1970-1990. , 1994, American journal of epidemiology.

[61]  Sj Senn,et al.  Odds ratios revisited , 1998 .

[62]  K. Ottenbacher.  Quantitative evaluation of multiplicity in epidemiology and public health research. , 1998, American journal of epidemiology.

[63]  S Greenland,et al.  Can meta-analysis be salvaged? , 1994, American journal of epidemiology.

[64]  J. Vandenbroucke,et al.  Observational research and evidence-based medicine: What should we teach young physicians? , 1998, Journal of clinical epidemiology.

[65]  D G Altman,et al.  Statistics notes: Interaction 3: How to examine heterogeneity , 1996 .

[66]  Allan Donner,et al.  Some aspects of the design and analysis of cluster randomization trials , 2002 .

[67]  D Curran-Everett,et al.  Fundamental concepts in statistics: elucidation and illustration. , 1998, Journal of applied physiology.

[68]  M. Bracken,et al.  Clinically useful measures of effect in binary analyses of randomized trials. , 1994, Journal of clinical epidemiology.

[69]  L E Moses,et al.  Combining independent studies of a diagnostic test into a summary ROC curve: data-analytic approaches and some additional considerations. , 1993, Statistics in medicine.

[70]  D. Potvin,et al.  Multistage designs for phase II clinical trials: statistical issues in cancer research. , 1996, British Journal of Cancer.

[71]  J E Cottrell,et al.  Absence of evidence is not evidence of absence. , 1983, Anesthesiology.

[72]  J. Vandenbroucke,et al.  Low-molecular-weight heparin versus standard heparin in general and orthopaedic surgery: a meta-analysis , 1992, The Lancet.

[73]  D. Spiegelhalter,et al.  Reliability of league tables of in vitro fertilisation clinics: retrospective analysis of live birth rates. , 1998, BMJ.

[74]  U Grouven,et al.  Logistic regression models used in medical research are poorly presented , 1996, BMJ.

[75]  S. Greenland.  Quality Scores Are Useless and Potentially Misleading: Reply to “Re: A Critical Look at Some Popular Analytic Methods” , 1994 .

[76]  C Bain,et al.  Choosing between randomised and non-randomised studies: a systematic review. , 1998, Health technology assessment.

[77]  J. Hall,et al.  Methodologic standards in surgical trials. , 1996, Surgery.

[78]  S. Greenland.  Dose‐Response and Trend Analysis in Epidemiology: Alternatives to Categorical Analysis , 1995, Epidemiology.

[79]  M. Stokes,et al.  Reliability of assessment tools in rehabilitation: an illustration of appropriate statistical analyses , 1998, Clinical rehabilitation.

[80]  W B Jonas,et al.  Impact of study quality on outcome in placebo-controlled trials of homeopathy. , 1999, Journal of clinical epidemiology.

[81]  D. Hand,et al.  Improving the Quality of Statistics in Psychiatric Research , 1995, British Journal of Psychiatry.

[82]  G. Glass.  Primary, Secondary, and Meta-Analysis of Research1 , 1976 .

[83]  Valérie Buthion,et al.  ColoNav: patient navigation for colorectal cancer screening in deprived areas – Study protocol , 1999, BMC Cancer.

[84]  F. Davidoff.  In the teeth of the evidence: the curious case of evidence-based medicine. , 1999, The Mount Sinai journal of medicine, New York.

[85]  D G Altman,et al.  Statistics in medical journals: developments in the 1980s. , 1991, Statistics in medicine.

[86]  N. Cozens.  Should we have confidence in radiology papers? , 1994, Clinical radiology.

[87]  P Glasziou,et al.  Meta-analytic methods for diagnostic test accuracy. , 1995, Journal of clinical epidemiology.

[88]  H Brenner,et al.  Controlling for Continuous Confounders in Epidemiologic Research , 1997, Epidemiology.

[89]  K J Rothman,et al.  A show of confidence. , 1978, The New England journal of medicine.

[90]  A R Jadad,et al.  Assessing the quality of randomized controlled trials: an annotated bibliography of scales and checklists. , 1995, Controlled clinical trials.

[91]  W. Vach,et al.  On the misuses of artificial neural networks for prognostic and diagnostic classification in oncology. , 2000, Statistics in medicine.

[92]  D G Altman,et al.  Transfer of technology from statistical journals to the biomedical literature. Past trends and future predictions. , 1994, JAMA.

[93]  C. Rembold.  Number needed to screen: development of a statistic for disease screening , 1998, BMJ.

[94]  A Donner,et al.  A methodological review of non-therapeutic intervention trials employing cluster randomization, 1979-1989. , 1990, International journal of epidemiology.

[95]  L E Moses,et al.  Estimating Diagnostic Accuracy from Multiple Conflicting Reports , 1993, Medical decision making : an international journal of the Society for Medical Decision Making.