Poor agreement in significant findings between meta-analyses and subsequent large randomized trials in perioperative medicine

Abstract

Background The reliability of meta-analysis (MA) in predicting the findings of subsequent large randomized controlled trials (RCTs) has not been assessed in perioperative medicine and anaesthesia. Methods Using Medline and PubMed, large RCTs (n≥1000) published since 2000 in the anaesthesia and perioperative medicine/critical care literature were identified. All previous MAs of RCTs investigating the same intervention and population were sourced. For all reported major morbid endpoints common to each, results (significant/non-significant P<0.05) were compared. Results 18 large RCTs and 44 prior MAs investigating the effects of 16 interventions were identified. Where endpoint results in the la..