Meta-Analyses and Large Randomized, Controlled Trials

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Abstract
We were pleased to see that using an independent protocol, LeLorier et al. (Aug. 21 issue)1 confirmed both our2 previous estimates of the frequency of discrepancies between large trials and meta-analyses and those of Villar et al.3 Their selection of 12 large trials from four influential journals may have inflated the frequency of apparent discrepancies. Such journals may tend to publish trials that are likely to change practice, whose results disagree with prior evidence.4 Still, the estimates of LeLorier et al. are largely similar to prior estimates. However, we are concerned that several of their premises propagate outdated myths.