Intended for healthcare professionals

Rapid response to:


Pharmaceutical industry sponsorship and research outcome and quality: systematic review

BMJ 2003; 326 doi: (Published 29 May 2003) Cite this as: BMJ 2003;326:1167

Rapid Response:

Misleading Meta-Metaanalysis

Misleading meta-meta-analysis

Those of us working at the coalface of clinical practice struggle to
ensure our work is evidence based and that are critical appraisal skills
are up to the mark. We toil long hours and look forward to our weekly
evidence based journal club where a mixture of grades and levels of
experience come together, usually over a sponsored sandwich, to do battle
with another research paper. However, all too often these articles are
over long, poorly written and insufficiently edited. Our only respite
tends to be when an article from the BMJ is selected – telling us all we
need to know in a punchy 2000 words. When the train spotters amongst us
want more – there is the electronic long version

We enjoyed the timely and illuminating themed issue on the
pharmaceutical industry and the medical profession and had selected Joel
Lexchin et al’s systematic review for critical discussion. We feel badly
let down by the ‘paper short’ version of this review, which was at best
misleading, and at worst confusing and inaccurate. The whole paper reads
as if it were a review of primary studies, rather than what it was – a
review of other peoples reviews. There were a number of methodological
issues, including (1) double counting of evidence and (2) reviewing non-
systematic reviews that cast doubts on the validity of this approach. It
was difficult to tell what the authors had actually done in the shortened
version of the paper. We wonder if this was a ‘cut too far’ and would
urge the BMJ editorial staff to consider whether the readability and
clarity of papers is being sacrificed in search of brevity when producing
shortened paper versions.

Yours sincerely

Charlotte Ford

Senior house officer in psychiatry


Simon Gilbody

Senior lecturer in mental health services research

Competing interests:  
None declared

Competing interests: No competing interests

03 July 2003
Charlotte Ford
Senior house officer in psychiatry
Simon Gilbody