Document Detail

Conflicting conclusions from two systematic reviews of epidural steroid injections for sciatica: which evidence should general practitioners heed?
MedLine Citation:
PMID:  10622020     Owner:  NLM     Status:  MEDLINE    
Systematic reviews and meta-analyses are becoming increasingly important in informing clinical practice and commissioning. Two systematic reviews of a treatment for low back pain and sciatica using epidural steroid injections, published in the same year, arrived at conflicting conclusions. Only one was reported in a digest for evidence-based medicine. This paper aims to find the reasons for the discordance between the reviews, and draw conclusions for users of reviews. Using comparative analysis of two published systematic reviews and their source material, it was found that the two reviews had the same overall aims and met the criteria for review methods. They differed in their choice of methods, including the judgement of quality of studies for inclusion and for summing-up evidence. Estimation of summary odds ratios in one review led to stronger conclusions about effectiveness. In conclusion, the choice of methods for systematic review may alter views about the current state of evidence. Users should be aware that systematic reviews include an element of judgement, whatever method is used.
K Hopayian; M Mugford
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  The British journal of general practice : the journal of the Royal College of General Practitioners     Volume:  49     ISSN:  0960-1643     ISO Abbreviation:  Br J Gen Pract     Publication Date:  1999 Jan 
Date Detail:
Created Date:  2000-01-24     Completed Date:  2000-01-24     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9005323     Medline TA:  Br J Gen Pract     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  57-61     Citation Subset:  IM    
School of Health, University of East Anglia, Norwich.
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MeSH Terms
Adrenal Cortex Hormones / therapeutic use*
Clinical Protocols
Evidence-Based Medicine
Injections, Epidural
Low Back Pain / drug therapy*
Randomized Controlled Trials as Topic
Sciatica / drug therapy*
Treatment Outcome
Reg. No./Substance:
0/Adrenal Cortex Hormones
Comment In:
Br J Gen Pract. 1999 Apr;49(441):314   [PMID:  10736916 ]
Erratum In:
Br J Gen Pract 1999 Oct;49(447):840

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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