The client needed to demonstrate that their core technology, intraoperative radiation therapy, was associated with a primary effectiveness outcome as good as the standard of care, but the studies that had been done were heterogeneous in important ways (e.g. length of follow up), making synthesis of the evidence and arriving at conclusion challenging. The client needed a creative, cost-effective solution to synthesize the evidence in a robust, scientifically defensible way. TTi conducted a meta-analysis of existing studies, including both RCTs and observational studies. Robust statistical approaches were used to address short-comings in individual studies and produce a pooled outcome estimate presented in a way physicians and other stakeholders would be expecting (e.g., 5-year local recurrence rate). The client was able to demonstrate and communicate the value of their technology by producing evidence at the top of the evidence pyramid. The results of this study have driven revenue and technology adoption for the client, by building a strong evidence base in this indication.