tematic Review and Meta-analysis of Experimental Stroke
Author: Malcolm Macleod
Honorary Fellow,
School of Molecular and Clinical Medicine,
University of Edinburgh,
Scotland,
UK
Received 14 May 2004; received in revised form 16 September 2004,; accepted 20 September 2004
Correspondence and requests for reprints should be addressed to:
Dr. Malcolm Macleod,
Division of Clinical Neurosciences
School of Molecular and Clinical Medicine
University of Edinburgh
Western General Hospital
Crewe Road
Edinburgh
EH4 2XU
United Kingdom
Tel: 44131 537 1000
Fax: 44131 651 1085
Email: malcolm@apoptosis.freeserve.co.uk
Absract
Objectives
Despite much experimental evidence demonstrating the efficacy of candidate neuroprotective drugs, no drug has made the transition to routine clinical use. One reason for this may be that the data from animal experiments was not analysed with sufficient rigour prior to the drugs being tested in clinical trial. Here we describe the application of the clinical trial methodologies of systematic review and meta-analysis to the analysis of drug efficacy studies in experimental stroke.
Methodology
Systematic review; meta-analysis
Results
Systematic review and meta-analysis of the efficacy of nicotinamide, melatonin and FK506 have been carried out, and the main findings reported elsewhere. Their findings raise important concerns regarding study quality and design, illuminate possible biological differences between candidate neuroprotective drugs, and provide evidence for a substantial publication bias for some neuroprotective drugs.
Conclusions
The implications of these findings for the research community, and a strategy to extend the use of these techniques in experimental stroke, are discussed. We propose a research agenda to support the development of appropriate meta-analysis techniques for experimental stroke.
Key Words
Systematic review; meta-analysis; experimental stroke; nicotinamide; FK506; melatonin
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