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Meta-analyses of Hydroxyethyl Starch for Volume Resuscitation

John P. A. Ioannidis, MD, DSc
JAMA. 2013;309(21):2209. doi:10.1001/jama.2013.5817.
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To the Editor: Most textbooks and guidance documents on systematic reviews discuss the caveats and potential risks of heterogeneity in meta-analysis. It is not appreciated that extreme homogeneity in a meta-analysis can be a far stronger signal of major problems.1 The careful meta-analysis of hydroxyethyl starch for fluid resuscitation by Dr Zarychanski and colleagues2 exemplifies this issue.

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June 5, 2013
Ryan Zarychanski, MD, MSc; Alexis F. Turgeon, MD, MSc; Ahmed M. Abou-Setta, MD, PhD
JAMA. 2013;309(21):2209. doi:10.1001/jama.2013.5820.
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