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International Journal of Epidemiology 2002;31:105-106
© International Epidemiological Association 2002

Special Theme: Systematic Reviews and Meta-Analysis

Commentary: Biostatistics, biological mechanisms and Bayes: lessons from the magnesium trials

KL Woods

Department of Medicine, 4th Floor, Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE2 7LX, UK. E-mail: klw@le.ac.uk

The controversy which has surrounded the interpretation of the randomized controlled trials (RCT) of intravenous Mg2+ in acute myocardial infarction has focused attention on the place of both meta-analysis and the mega-trial in therapeutic research. Stated simply, a fixed-effects meta-analysis of seven small controlled trials indicated a highly significant 55% reduction in odds of death among Mg2+ treated patients. These early findings prompted a conventionally powered RCT in 2300 patients (LIMIT-2). Patients allocated to receive intravenous Mg2+ for 24 hours experienced relative reductions of 24% (95% CI : 1–43%) in 28-day mortality, 25% (95% CI : 7–39%) . . . [Full Text of this Article]

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