Underutilization of Meta-analysis in Diagnostic Pathology

Abstract

Context.— No studies to our knowledge have investigated citations and utilization of meta-analysis in diagnostic pathology (DP). Objective.— To characterize meta-analyses in DP compared with meta-analyses in medicine. Design.— We searched PubMed for meta-analyses in 12 major DP journals without specifying years and in 4 major medicine journals in both 2006 and 2011. We compared articles' adjusted citation ratios (ACRs), defined as an article's citation count divided by the mean citations for the meta-analysis, review, and original research articles published in the same journal in the same year. Results.— Forty-one of 76 DP articles, 74 of 125 medicine articles in 2011, and 52 of 83 medicine articles in 2006 were qualified meta-analyses as identified by PubMed. The ACRs of DP meta-analysis articles were higher than those of original research articles (2.62 ± 2.31 versus 0.92 ± 0.84, P < .001) and similar to those of review articles in 2006 (2.62 ± 2.31 versus 1.95 ± 1.59, P = .50), but they were similar to both in 2011 (1.85 ± 1.39 versus 0.99 ± 1.43, P = .11; 1.85 ± 1.39 versus 1.12 ± 1.43, P = .21, respectively). Diagnostic pathology and medicine meta-analyses had similar ACRs (1.85 ± 1.39 versus 1.57 ± 1.35 in 2011, P = .60; and 2.62 ± 2.31 versus 1.85 ± 1.90 in 2006, P = .50, respectively). However, although DP journals published fewer meta-analyses (0.97% versus 6.66% in 2011 and 0.67% versus 4.40% in 2006, P < .001 for both), they published more meta-analyses using both original and published data than medicine (21.95% versus 1.59%, P < .001). They also published more meta-analyses per year in 2011–2014 than in 2000–2010 (6.4 ± 1.29 versus 1.36 ± 1.03 articles per year, P < .001). Conclusions.— We found underutilization of meta-analyses in DP, despite their high ACRs and recently increased utilization. More DP meta-analyses are needed.