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The article focuses on the efficiency of practicing meta-analysis of randomized clinical trials (RCTs) in detecting patients' diseases in Great Britain. Conducting meta-analysis is important because it determines whether patients were able to receive the appropriate medical care. The randomization and binding process derived from Cochrane Hepato-Biliary module was used in assessing patient's treatment.

Background Colorectal cancer may be prevented by reducing the development of adenomatous polyps. Aim To assess the benefits and harms of antioxidant supplements in preventing colorectal adenoma. Methods Using the Cochrane Collaboration methodology we reviewed all randomized clinical trials comparing antioxidant supplements with placebo or no intervention. We searched electronic databases and the reference lists until October 2005. Outcome measures were development of colorectal adenoma adverse events. We analysed dichotomous outcomes with fixed- and random-effects model meta-analyses and calculated the relative risk with 95% confidence interval. Results We identified eight randomized trials (17 620 participants). Neither fixed-effect (relative risk: 0.93, 95% CI: 0.81–1.1) nor random-effect model meta-analyses (0.82, 0.60–1.1) showed statistically significant effects of supplementation with β-carotene, vitamins A, C, E and selenium alone or in combination. Antioxidant supplements seemed to increase the development of colorectal adenoma in three low-bias risk trials (1.2, 0.99–1.4) and significantly decrease its development in five high-bias risk trials (0.59, 0.47–0.74). The estimates difference is significant ( P < 0.0001). There was no significant difference between the intervention groups regarding adverse events, including mortality (0.82, 0.47–1.4). Conclusion We found no convincing evidence that antioxidant supplements have significant beneficial effect on primary or secondary prevention of colorectal adenoma. [ABSTRACT FROM AUTHOR]

The authors discuss their response on the comments regarding their article on transient elastography for staging liver fibrosis in alcoholic liver disease. They agree that their article is based on their Cochrane systematic review but stress that including data from the two studies will not influence the results of the meta-analyses. They argue against the comment that the mixed aetiology in the 50% of the included studies is a limitation of their review.