Year: 2009
Type: letter
Abstract: In their recent article, Fuchs-Buder et al. [1] echoed concerns regarding our meta-analysis [2], concerns initially raised by others [3]. We have published a detailed rebuttal [4], which we will reiterate in brief here. They claimed that we made no distinction between objective and non-objective monitoring methods in our meta-analysis. This is incorrect. We found no evidence supporting the hypothesis that the use of quantitative neuromuscular function monitors is superior to conventional monitors in reducing the incidence of postoperative residual curarisation [4]. We have little doubt that in the hands of an educated anaesthetist the use of even a conventional nerve stimulator will result in fewer cases of post-operative residual weakness than will occur following reliance on purely clinical signs. Nevertheless, an objective review of the literature fails to provide data to support this position. Good science depends on the presentation of data which may prove to be at odds with one’s beliefs. Ultimately, an argument is not false just because it has not been proven true. The second concern raised by Fuchs-Buder et al. relates to the inclusion of comparative and non-comparative studies in our meta-analysis. As we indicated in our rebuttal [4], that using very narrow inclusion criteria would result in more homogenous data at the cost of excluding valuable studies, introducing bias, and making the data less generalisable [5]. Horlocker and Brown [6] stated: ‘Clinical questions pertinent to the practice of anaesthesiology frequently do not meet criteria for high-level evidence as judged by evidence-based medicine advocates.’ Without meta-analysis, heterogeneity and weight cannot be determined, and they definitely cannot be determined by simple categorisation and data description.
Source: Anaesthesia
Authors: M. Naguib, A. A. Kopman
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1970151011