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Comment & Response
May 21, 2019

Meta-analysis of Opioids for Chronic Pain

Author Affiliations
  • 1Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester
JAMA. 2019;321(19):1935-1936. doi:10.1001/jama.2019.2181

To the Editor Following the discussion by Serghiou and Goodman,1 a closer examination of the application and reporting of the random-effects meta-analyses by Dr Busse and colleagues2 suggests additional caveats and questions.

Busse and colleagues2 did not explain their primary use of the DerSimonian-Laird method and their secondary use of the Hartung-Knapp-Sidik-Jonkman (HKSJ) method for the sensitivity analysis instead of using the superior HKSJ method throughout.3 Cornell et al4 summarized accumulated evidence that the DerSimonian-Laird method produces biased estimates. The biases would also affect the HKSJ method, which uses the same midpoint as the DerSimonian-Laird approach.