Abstract
Despite official support for the efficacy of cholesterol reduction, considerable controversy exists, and meta-analyses of this topic have produced conflicting results. The authors assessed the variability of meta- analyses, evaluating the cardiovascular value of cholesterol reduction while attempting to explain the variability. Meta-analyses were identified by electronic search and citation tracking. Included were those conducted prior to 1995 that dealt with cholesterol reduction and total mortality, cardiovascular mortality, or nonfatal cardiovascular disease. In addition to extracting odds ratios for total mortality, cardiovascular mortality, and nonfatal cardiovascular disease, the authors encoded methodological variables, publication variables, and data concerning investigators' backgrounds. Twenty-three meta-analyses were reviewed, and 15 concluded that cholesterol reduction was beneficial. Summary odds ratios for total mortality were heterogeneous, generally failing to support the value of cholesterol reduction. Odds ratios depended on inclusion criteria and investigator variables. Odds ratios for cardiovascular mortality and for nonfatal cardiovascular disease were more homogeneous and supported the value of cholesterol reduction. Methodologically better meta-analyses tended to report more beneficial odds ratios. Although 'supportiveness' of the value of cholesterol reduction was associated with inclusion/exclusion criteria and publication variables, the primary outcome variable related to supportiveness was the statistical significance of the odds ratios for cardiovascular mortality.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 429-441 |
| Number of pages | 13 |
| Journal | American Journal of Epidemiology |
| Volume | 149 |
| Issue number | 5 |
| State | Published - Mar 1 1999 |
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Keywords
- Cardiovascular diseases
- Hypercholesterolemia
- Meta-analysis
- Research design
ASJC Scopus subject areas
- Epidemiology
Cite this
Variability in meta-analytic results concerning the value of cholesterol reduction in coronary heart disease : A meta-meta-analysis. / Katerndahl, David A; Lawler, William R.
In: American Journal of Epidemiology, Vol. 149, No. 5, 01.03.1999, p. 429-441.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Variability in meta-analytic results concerning the value of cholesterol reduction in coronary heart disease
T2 - A meta-meta-analysis
AU - Katerndahl, David A
AU - Lawler, William R
PY - 1999/3/1
Y1 - 1999/3/1
N2 - Despite official support for the efficacy of cholesterol reduction, considerable controversy exists, and meta-analyses of this topic have produced conflicting results. The authors assessed the variability of meta- analyses, evaluating the cardiovascular value of cholesterol reduction while attempting to explain the variability. Meta-analyses were identified by electronic search and citation tracking. Included were those conducted prior to 1995 that dealt with cholesterol reduction and total mortality, cardiovascular mortality, or nonfatal cardiovascular disease. In addition to extracting odds ratios for total mortality, cardiovascular mortality, and nonfatal cardiovascular disease, the authors encoded methodological variables, publication variables, and data concerning investigators' backgrounds. Twenty-three meta-analyses were reviewed, and 15 concluded that cholesterol reduction was beneficial. Summary odds ratios for total mortality were heterogeneous, generally failing to support the value of cholesterol reduction. Odds ratios depended on inclusion criteria and investigator variables. Odds ratios for cardiovascular mortality and for nonfatal cardiovascular disease were more homogeneous and supported the value of cholesterol reduction. Methodologically better meta-analyses tended to report more beneficial odds ratios. Although 'supportiveness' of the value of cholesterol reduction was associated with inclusion/exclusion criteria and publication variables, the primary outcome variable related to supportiveness was the statistical significance of the odds ratios for cardiovascular mortality.
AB - Despite official support for the efficacy of cholesterol reduction, considerable controversy exists, and meta-analyses of this topic have produced conflicting results. The authors assessed the variability of meta- analyses, evaluating the cardiovascular value of cholesterol reduction while attempting to explain the variability. Meta-analyses were identified by electronic search and citation tracking. Included were those conducted prior to 1995 that dealt with cholesterol reduction and total mortality, cardiovascular mortality, or nonfatal cardiovascular disease. In addition to extracting odds ratios for total mortality, cardiovascular mortality, and nonfatal cardiovascular disease, the authors encoded methodological variables, publication variables, and data concerning investigators' backgrounds. Twenty-three meta-analyses were reviewed, and 15 concluded that cholesterol reduction was beneficial. Summary odds ratios for total mortality were heterogeneous, generally failing to support the value of cholesterol reduction. Odds ratios depended on inclusion criteria and investigator variables. Odds ratios for cardiovascular mortality and for nonfatal cardiovascular disease were more homogeneous and supported the value of cholesterol reduction. Methodologically better meta-analyses tended to report more beneficial odds ratios. Although 'supportiveness' of the value of cholesterol reduction was associated with inclusion/exclusion criteria and publication variables, the primary outcome variable related to supportiveness was the statistical significance of the odds ratios for cardiovascular mortality.
KW - Cardiovascular diseases
KW - Hypercholesterolemia
KW - Meta-analysis
KW - Research design
UR - http://www.scopus.com/inward/record.url?scp=0033105802&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033105802&partnerID=8YFLogxK
M3 - Article
C2 - 10067902
AN - SCOPUS:0033105802
VL - 149
SP - 429
EP - 441
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
SN - 0002-9262
IS - 5
ER -