Abstract：
With each update of meta-analyses from living systematic reviews, treatment effects and their confidence intervals are recalculated. This often raises the question whether or not multiplicity is an issue and whether a method to adjust for multiplicity is needed. It seems that answering these questions is not that straightforward. We approach this matter by considering the context of systematic reviews and pointing out existing methods for handling multiplicity in meta-analysis. We conclude that multiplicity is not a relevant issue in living systematic reviews when they are planned with the aim to provide up-to-date evidence, without any direct control on the decision over future research. Multiplicity might be an issue, though, in living systematic reviews designed under a protocol involving a \"stopping decision\", which can be the case in living guideline development or in reimbursement decisions. Several appropriate methods exist for handling multiplicity in meta-analysis. Existing methods, however, are also associated with several technical and conceptual limitations, and could be improved in future methodological projects. To better decide whether an adjustment for multiplicity is necessary at all, authors and users of living systematic reviews should be aware of the context of the work and question whether there is a dependency between the effect estimates of the living systematic review and its stopping/updating or an influence on future research.
摘要：
随着实时系统评价的荟萃分析的每次更新，重新计算治疗效果及其置信区间。这通常会提出一个问题，即多重性是否是一个问题，以及是否需要一种针对多重性进行调整的方法。似乎回答这些问题并不是那么简单。我们通过考虑系统评论的背景并指出在荟萃分析中处理多重性的现有方法来解决这一问题。我们得出的结论是，当计划以提供最新证据为目的时，多重性在生活系统评价中不是一个相关问题。对未来研究的决定没有任何直接控制。多重性可能是个问题，虽然,在根据涉及“停止决定”的协议设计的生活系统评价中，这可能是生活指南制定或报销决定的情况。存在几种适当的方法来处理荟萃分析中的多重性。现有方法,然而,也与几个技术和概念限制有关，并可以在未来的方法项目中得到改进。为了更好地决定是否需要对多重性进行调整，生活系统评价的作者和使用者应了解工作的背景，并质疑生活系统评价的效果估计与其停止/更新之间是否存在依赖性或对未来研究的影响。
