World Sleep 2022 | Meta-analyses in sleep medicine

Gabriel Pires, PhD, Federal University of São Paulo, São Paulo, Brazil, discusses the recent use of meta-analyses in sleep medicine. Meta-analysis is a quantitative, formal, epidemiological study design used to systematically assess previous research studies – typically demonstrating the highest level of medical evidence. However, Dr Pires discusses a recent change in the quality of meta-analyses since the COVID-19 pandemic. Researchers have been performing meta-analyses in much greater volume than before – around one meta-analysis is published every six days, making it difficult to follow the progression of literature. This is a result of continuing research at home without access to laboratories. The quantity of meta-analyses published has also not been consistent with quality; some studies’ lack of criteria has resulted in difficulty separating the reliable meta-analyses from the non-reliable ones. Dr Pires states that we should not consider meta-analyses as the undoubtful, highest level of evidence; a poorly performed meta-analysis will bring less evidence than a well-performed, randomized control trial. What was seen during the pandemic was a publishing/pressure paradigm – whereby there was immense pressure to publish. This could have been the reason for low-level criteria being implemented and thus, resulted in a lack of reliability across a range of studies. Meta-analyses should only be performed when there are reasonable methodological parameters, when there are sensible criteria from a statistical and practical point of view, and when they follow the best standards available. Supported by well-known researchers in the field of meta-analyses, this would provide the gold standard. This interview took place at the World Sleep Congress 2022 in Rome, Italy.