Meta-Analyses of Randomised Trials
In many areas of clinical medicine, it is common to find multiple randomised trials that address a similar question. Meta-analysis is a statistical technique for combining the findings of such trials. Our work on meta-analysis of randomised trials is distinctive because it typically involves analysis of large datasets of anonymised data on individual patients, rather than the more typical summaries of trial findings. The availability of such data allows detailed information to be obtained on the benefits and hazards of drugs.
Most of our meta-analyses involve international collaboration with investigators to frame the scientific questions and to analyse and interpret the findings. Our work with investigators in cancer medicine, such as the Early Breast Cancer Trialists' Collaborative Group (EBCTCG), has helped to improve the care of patients with breast cancer by providing reliable assessments of treatments that involve some decades of follow-up from trials.
In vascular disease, the work of the Cholesterol Treatment Trialists’ (CTT) Collaboration, the Antithrombotic Trialists’ (ATT) Collaboration, and the Stroke Thrombolysis Trialists’ (STT) Collaboration has helped to determine the balance of beneficial and harmful effects of drugs used for the treatment of prevention of conditions such as heart attacks and strokes. We have also investigated the hazards of commonly used drugs; the Coxib and traditional NSAID Trialists’ (CNT) Collaboration, examined the cardiovascular risks of the commonest class of painkillers used for muscle and joint disorders (nonsteroidal anti-inflammatory drugs –NSAIDs).
The findings of these influential international collaborations have been widely incorporated into treatment guidelines used by doctors in the care of their patients.
Other ongoing projects include the Gastroprotectant Trialists’ (GPT) Collaboration, which is assessing the effects of treatments used to prevent and treat peptic ulcer disease (such as histamine 2 receptor antagonists and proton pump inhibitors- PPIs), and the Marfan Treatment Trialists’ (MTT) Collaboration which is assessing the effects of treatments in a genetic condition known as Marfan syndrome.