An Epidemic of Redundant Meta-analyses.

BACKGROUND Meta-analyses are widely used to strengthen available evidence and obtain more precise estimates of treatment effect than any individual trial. Paradoxically, multiplication of meta-analyses on the same topic can lead to confusion as practitioners no longer benefit from a rapid and synthetic response. This phenomenon may appear disproportionate when the number of published meta-analyses exceeds the number of original studies. OBJECTIVES To describe an example of redundant meta-analyses published in the same area with the same randomized clinical trials (RCTs). METHODS A systematic review was performed to identify all published meta-analyses of original RCTs that compared DOACs to LMWHs in cancer patients with venous thromboembolism (VTE). Forest plots were used to represent the meta-analyses results for efficacy (VTE recurrence) and safety (major bleeding) endpoints. An authors' network was constructed to explore the links between the authors of the published meta-analyses. RESULTS In the past 3 years, four original RCTs were the subject of 20 published meta-analyses by 142 authors: 5, 4 and 11 meta-analyses pooled the data of 2, 3 and 4 RCTs, respectively. The results of meta-analyses were similar regarding the risks of VTE recurrence and major bleeding. The 11 meta-analyses of 4 RCTs were published within 6 months of the publication of the last RCT. CONCLUSIONS The epidemic proportions of such redundant literature and authorship could be moderated by developing 'living' meta-analyses and encouraging authors of new RCTs to update the corresponding meta-analysis in the same paper as their original research.