Just as bluefin tuna are high on the aquatic food chain, systematic reviews and meta-analyses are at the top of the evidence hierarchy. Tuna swallow up smaller fish that have eaten minnows, which have eaten plankton and so on, accumulating the nutrients—and the toxins (eg, mercury)—of their prey. Meta-analyses, too, acquire and filter data and the misinformation (eg, biases) from the studies they aggregate. Indiscriminate consumption of tuna or meta-analyses can be hazardous to brain health.
Stein MB, Norman SB. When Does Meta-analysis of a Network Not Work? Fishing for Answers. JAMA Psychiatry. Published online June 12, 201976(9):885–886. doi:10.1001/jamapsychiatry.2019.0902
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