Applying a Meta-Analysis to Daily Clinical Practice

Miser, William F. MD, MA

From the Department of Family Medicine, The Ohio State University, Columbus.

Submitted, revised, 8 March 1999.

Address reprint requests to William F. Miser, MD, MA, Rardin Family Practice Center, 2231 North High St, Columbus, OH 43201.

This article was reprinted with permission from Miser WF. Applying a meta-analysis to daily clinical practice. In Geyman JP, Deyo RA, Ramsey SD, editors. Evidence-based clinical practice: concepts and approaches. Boston: Butter-worth-Heinemann, 2000:57-64.

Journal of the American Board of Family Practice 13(3):p 201-210, May-June 2000.

You are seeing a cranky 4-year-old boy who has a low-grade fever and symptoms of an upper respiratory tract infection. On examination he appears nontoxic but definitely has a left otitis media. He has previously been healthy and has no history of an ear infection. You want to prescribe antibiotics, but family finances are tight (both parents are laid off from work), and the child hates to take any type of medicine. As you discuss the situation with the parents, you remember an article published recently that suggested childhood otitis media could be effectively treated with a shorter course of antibiotics. You write a prescription for a 5-day course of amoxicillin and tell the parents you will telephone toward the end of treatment to determine whether a longer course is needed. In the meantime, you find the article titled "Treatment of Acute Otitis Media With a Shortened Course of Antibiotics - A Meta-Analysis." You have seen the term meta-analysis before but are unsure how to critique the article.