The meta-analytic paradox: the primary reason that meta-analysis exists is because of small and pointless underpowered trials. The primary problem with meta-analysis is that they are amplifying small and pointless underpowered trials.
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I'm probably being naive, but if you can't afford to do a trial properly, then why do it at all? Aren't you just generating junk data?
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Sometimes people do small trials hoping to find big effects. Big trials are super-expensive. A smaller effect won't show up as significant, even if it's big enough to matter clinically if it turns out to be real. Then simple meta-analysis helps sort that out.
End of conversation
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