ABSTRACT
In two recent studies, the Institute of Medicine (IOM) of the National Academy of Sciences has developed and applied new techniques of research synthesis, including meta-analysis, to help clarify politically charged policy issues. The Congress requested these studies because of concern that people who were suffering adverse health outcomes deserved compensation. The health outcomes were thought to be due to exposure to chemicals used in Vietnam in one case, and to the use of childhood vaccines in the other. As a non-governmental agency, the IOM cannot make compensation policy, but it can assess and summarize the existing scientific evidence to inform the federal agencies charged with these decisions. In both projects, the IOM used meta-analysis for combining statistical information wherever possible. The lOM’s response to these two congressional mandates is contained in four reports (1-4), from which this paper is largely drawn. The purpose of this paper is to illustrate the approach that the IOM has taken, with a focus on statistical aspects of the analysis, and to discuss the potential applicability of this approach in other settings.*
The National Academy of Sciences (NAS) is a unique private institution charged with advising the U.S. government on matters of science and public policy. It was chartered by Congress in 1863 to provide a mechanism for eminent scientists and engineers to “investigate, examine, experiment, and report upon any subject of science or art” requested by the government. The Institute of Medicine was established in 1970 by the NAS to enlist distinguished medical and other professionals to study issues that affect public health. Like the NAS, the IOM conducts studies on particular topics and has a distinguished elected membership.
