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June 12, 2019

When Does Meta-analysis of a Network Not Work?Fishing for Answers

Author Affiliations
  • 1Department of Psychiatry, University of California San Diego, La Jolla
  • 2Department of Family Medicine and Public Health, University of California San Diego, La Jolla
  • 3VA San Diego Healthcare System, San Diego, California
  • 4National Center for PTSD, White River Junction, Vermont
JAMA Psychiatry. 2019;76(9):885-886. doi:10.1001/jamapsychiatry.2019.0902

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.