Practice-changing meta-analysis

• Does the Setting of External Ventricular Drain Placement Affect Morbidity? A Systematic Literature Review Comparing Intensive Care Unit versus Operating Room Procedures

A practice-changing meta-analysis is a type of high-impact systematic review that synthesizes existing evidence across multiple studies in a way that significantly alters clinical practice guidelines or decision-making. These meta-analyses often:

Aggregate high-quality data (often from randomized controlled trials).

Provide statistically robust findings that clarify uncertainties in previous literature.

Challenge or confirm standard-of-care treatments.

Prompt updates in clinical guidelines from major health organizations.

Lead to measurable changes in how clinicians treat patients.

Example Characteristics: Large effect size with narrow confidence intervals.

Clear superiority or inferiority of an intervention.

Implications for safety, cost, or mortality.

Published in high-impact journals (e.g., NEJM, The Lancet, JAMA).

Real-World Examples: DARE meta-analysis (2005): Changed the way beta-blockers are used in heart failure.

Mammography screening meta-analyses: Influenced guidelines on the age and frequency of breast cancer screening.

Meta-analyses of thrombectomy in acute stroke: Changed stroke management worldwide.