Abstract
Aims and methodPrompted by a clinical question, we critically appraised a meta-analysis of neuroimaging in our evidence-based journal club.ResultsThe results of the meta-analysis suggested differences in ventricular size and sulcal width between controls and people with schizophrenia and mood disorders. However, we were unable to answer the question that prompted this exercise.Clinical implicationsAlthough the evidence-based medicine approach facilitates appraisal of complex articles, some clinical questions are not yet answerable.
Highlights
Accurate searching of electronic databases is a cornerstone of evidence-based medicine
In retro spect we should have searched the Cochrane database of systematic reviews (Bero & Rennie, 1995), which is a source of reviews carried out to specified standards
A reviewer comes to a conclusion based on the number of studies showing a positive effect, a negative effect or no effect
Summary
The resultsof the meta-analysis suggested differences in ventricular size and sulcal width between controls and people with schizophrenia and mood disorders. Clinical implications the evidence-based medicine approach facilitates appraisal of complex articles, some clinical questions are not yet answerable. Having 'no power to control things' and feeling 'mentally and physically tired'. Careful clinical evaluation over time has left us uncertain about whether the diagnosis is schizophrenia or depression. During discussion of this case, the question of whether any investigations, brain imaging, would help to clarify the diagnosis arose. The results of meta-analyses should not be accepted un critically This example of a critique of a metaanalysis, taken from our journal club, shows how the evidence-based approach can simplify and clarify a complex article and provide the appraiser with a framework for assessing the validity and results
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