How to critically appraise and apply meta-analyses in clinical practice

摘要: Aim:  Prompted by a clinical question, we critically appraised meta-analysis of efficacy and safety mycophenolate mofetil (MMF) versus cyclophosphamide (CYC) in the treatment proliferative lupus nephritis. Methods:  Systemic reviews are introduced to reader perspective scenario that raises questions about applicability certain options practice. Critical appraisal addresses three questions. (i) What results? (ii) Are results valid? (iii) How can I apply my patient care? Results:  A paper titled ‘Mycophenolate is as efficacious as, but safer than, nephritis: meta-regression’by Mak et al. (2009) was selected. Our critical identified several strengths paper, such having clearly focused considering clinically important outcomes, using appropriate inclusion criteria select primary studies, assessing quality selected papers, good reproducibility assessment studies performing sensitivity analysis meta-regression account for heterogeneity. Nevertheless, also weaknesses, possibly missing out other relevant possible selection bias, low some used lack data on cost effectiveness. Conclusion:  Meta-analyses have an role implementation evidence-based practice shaping future research. Despite undoubted advantages, meta-analyses no panacea. Caution, therefore, has be applied when practice, due methodological limitations used.