Journal Information
Vol. 9. Issue 49.
Pages 265-272 (July - August 1995)
Vol. 9. Issue 49.
Pages 265-272 (July - August 1995)
Open Access
Inclusión de la calidad de una investigación en, el metanálisis*
Inclusion of Investigation Quality in Meta-Analysis
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Miguel Delgado-Rodríguez1,**, María Sillero Arenas2
1 Cátedra de Medicina Preventiva y Salud Pública. Facultad de Medicina, Universidad de Cantabria
2 Delegación Provincial de la Salud, Jaén
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Resumen

El objetivo de la presente revisión es la forma de considerar la calidad de un estudio en la síntesis de información procedente de varias investigaciones. Se ha criticado al metanálisis el que no valora de manera adecuada la calidad de una investigación, lo que puede resultar en que los estudios pobres desplacen a los buenos por el peso de los números. La inclusión de la calidad de una investigación en el metanálisis cuantitativo es un aspecto debatido en la actualidad. Está claro que es necesario determinar la calidad de un estudio. Sin embargo, y aunque existe un cierto grado de consenso en lo que es un buen estudio y cuáles son las características que debe reunir, no hay un protocolo de evaluación unánimemente aceptado. Otros problemas añadidos son la falta de validaciín de los cuestionarios existentes y la no comprobación de la reproducibilidad de sus resultados. Existen varios procedimientos para incorporar la calidad en el metanálisis: a) es aceptado de manera general que un estudio haya de reunir una calidad mínimay esté libre de sesgos importantes; b) se tiende a rechazar la incorporación de la calidad como criterio de ponderación; c) existen dudas acerca de los analisis gráficos o de regresión en los que se relacione la magnitud del efecto con la calidad global. Puede ser superfluo o erróneo.

Palabras clave:
Metanálisis
Calidad
Summary

The objective of this review is how study quality is taken into account in the synthesis of information from several studies. Meta-analysis has been criticized for failing into account differential quality of evidence in primary studies, allowing poor studies to drive out good science by weight of numbers. Notwithstanding there is presently no agreement on the inclusion of atudy quality score in quantitative meta-analysis; on the other hand, agreementdoes existon knowing study quality. However, and although there is a certain level of consensus about what a good study is and on what characteristics it should have, no evaluation protocol on study quality is uniformly accepted. Furthermore, there are no data on the reliability and validity of quality questionnaires. There are several procedures to include study quality in meta-analysis: a) it is generally accepted that bias-free studies should be pooled only; b) most researches reject to include quality scores in the weight; and c) no agreement is reached on the use the quality scores as acovariate in graphical methods and regression analysis. It may be superfluous or misleading.

Key words:
Meta-analysis
Quality
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Presentado en parte a la XII Reunión Anual de la Sociedad Espanola de Epidemiología, Alicante, 1994.

Copyright © 1995. Sociedad Española de Salud Pública y Administración Sanitaria
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