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Fixed or random effects meta-analysis? Common methodological issues in systematic reviews of effectiveness
Abstract
Systematic review aims to systematically identify, critically appraise, and summarize all relevant studies that match predefined criteria and answer predefined questions. The most common type of systematic review is that assessing the effectiveness of an intervention or therapy. In this article, we discuss some of the common methodological issues that arise when conducting systematic reviews and meta-analyses of effectiveness data, including issues related to study designs, meta-analysis, and the use and interpretation of effect sizes.
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“Additionally, it was recommended that the protocol should define the methods to be used for risk of bias assessment, meta-analysis and exploration of heterogeneity [41, 42, 44].”
From Methods to systematically review and meta-analyse observational studies: a systematic scoping review of recommendations (2018) · cites this paper as [44]
In the citing paper
“The articles recommended that the protocol should state the objectives, hypotheses to be tested and the rationale of the review, [29] and that it should describe eligibility criteria [29, 33, 35, 36, 38, 39, 41], define the type of studies to be included [35, 37, 42, 44], and give the reason when including observational studies in the review [35, 37, 40].”
From Methods to systematically review and meta-analyse observational studies: a systematic scoping review of recommendations (2018) · cites this paper as [44]
In the citing paper
“Twenty-five (27%) articles gave recommendations on item “considering different study designs” [8, 29, 34, 35, 37–39, 42, 44, 49, 51, 56, 61, 65, 70, 73, 75, 76, 77–83], with publication dates between 1995 and 2016 (median year of publication 2007).”
From Methods to systematically review and meta-analyse observational studies: a systematic scoping review of recommendations (2018) · cites this paper as [44]
In the citing paper
“A variation of this recommendation was to exclude studies that are at high risk of bias [42, 44, 54, 73, 82].”
From Methods to systematically review and meta-analyse observational studies: a systematic scoping review of recommendations (2018) · cites this paper as [44]
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“However, others have suggested that a minimum of five studies is required to conduct such analyses (Tufanaru et al., 2015).”
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“For the studies examining the same intervention and same fixed parameter, continuous data and a random-effects model were used to consider the common effect of the intervention [61].”
MethodA Meta-analysis on Associated Risk of Mortality in Nonalcoholic Fatty Liver Disease
Fu, C. E., Ng, C. H., Yong, J. N., Chan, K. E., Xiao, J., Nah, B. K. Y., Bong, S. H. S., Win, K. M., Bwa, A. H., Lim, W. H., et al. (2022) · Endocrine Practice · doi:10.1016/j.eprac.2022.10.007 · Cited by 46
Santos, E. J. F., Farisoğulları, B., Dures, E. K., Geenen, R., & Machado, P. (2023) · RMD Open · doi:10.1136/rmdopen-2023-003350 · Cited by 45
“36 37 39 Egger’s regression test for funnel plot asymmetry were performed and it was considered that publication bias existed when the p value was less than 0.05.”
InfluentialFernandez, R. S., Zaky, F., Ekmejian, A. A., Curtis, E., & Lee, A. (2018) · Catheterization and Cardiovascular Interventions · doi:10.1002/ccd.27479 · Cited by 45
“Sensitivity analyses was performed by using the “leave one out” method to test the validity and robustness of the meta-analysis [21].”
MethodHou, M., Xing, H., Li, C., Wang, X., Deng, D., Li, J., Zhang, P., & Chen, J. (2020) · The Journal of Headache and Pain · doi:10.1186/s10194-020-01138-x · Cited by 45
Neuro-stimulation in focal epilepsy: A systematic review and meta-analysis
Skrehot, H. C., Englot, D. J., & Haneef, Z. (2023) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2023.109182 · Cited by 48
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“16 Heterogeneity was considered low, moderate, or considerable for I 2 values <40%, 40% to 75%, and >75%, respectively.”
Powell, N. R., Liang, T., Ipe, J., Cao, S., Skaar, T. C., Desta, Z., Qian, H.-R., Ebert, P. J., Chen, Y., Thomas, M. K., et al. (2023) · Nature Communications · doi:10.1038/s41467-023-37209-1 · Cited by 45
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“Statistical analyses were performed using random effects models [22].”
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“The effect estimates for each cognitive domain examined in at least two studies were, thereafter, separately pooled for aF and aM individuals using random-effects models (DerSimonian and Laird, 2015) to incorporate any apparent heterogeneity in study design and analytic approach between studies (Tufanaru et al., 2015).”
Interactive technology use and child development: A systematic review
Arabiat, D. H., Jabery, M. A. F. A., Robinson, S., Whitehead, L., & Mörelius, E. (2022) · Child Care Health and Development · doi:10.1111/cch.13082 · Cited by 41
“In agreement with the Joanna Briggs Institute recommendation for systematic review (JBI, 2014; Tufanaru et al., 2015), authors, when feasible, should include RCTs and quasi-experimental and observational studies in their review of impact or effectiveness.”
MethodAnticoagulant Treatment Regimens in Patients With Covid‐19: A Meta‐Analysis
Jorda, A., Siller-Matula, J. M., Zeitlinger, M. A., Jilma, B., & Gelbenegger, G. (2021) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt.2504 · Cited by 40
“com 616 generalize the findings beyond the included studies.(22,23) The statistical analysis was carried out using Review Manager (version 5.”
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“Pooled OR and its 95% CI were calculated using random-effect models for the generalization of results of meta-analysis (Tufanaru et al., 2015).”
Bahar, M. A., Kamp, J., Borgsteede, S. D., Hak, E., & Wilffert, B. (2018) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.13741 · Cited by 40
A systematic review of Amblyopia prevalence among the children of the world
Mostafaie, A., Ghojazadeh, M., Hosseinifard, H., Manaflouyan, H., Farhadi, F., Taheri, N., & Pashazadeh, F. (2020) · Romanian Journal of Ophthalmology · doi:10.22336/rjo.2020.56 · Cited by 40
“Statistical analyses were performed using random effect method [38].”
MethodEdwards, G., Jones, C. A., Pearson, E., Royston, R., Oliver, C., Tarver, J., Crawford, H., Shelley, L., & Waite, J. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104719 · Cited by 46
“Pooled prevalence estimates were generated using a random-effects model, as opposed to the fixed-effects model, as the former considers variation between studies and does not assume a common effect size (Hedges and Vevea, 1998; Tufanaru et al., 2015).”
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“A random-effects statistical model was selected for all analyses given that true clinical homogeneity could not be assumed.(18) Heterogeneity was assessed by I(2) statistics.”
MethodKhalil, A. I., Zhang, L., Muwonge, R., Sauvaget, C., & Basu, P. S. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-069616 · Cited by 41
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The Effectiveness of Yoga on Cancer-Related Fatigue: A Systematic Review and Meta-Analysis
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Trauma-focused treatments for depression. A systematic review and meta-analysis
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Rahman, H., Khan, S. U., Lone, A. N., Ghosh, P., Kunduru, M., Sharma, S., Sattur, S., & Kaluski, E. (2023) · Journal of the American Heart Association · doi:10.1161/jaha.123.030578 · Cited by 38
Khalafi, M., Maleki, A. H., Symonds, M. E., Rosenkranz, S. K., Rohani, H., & Ehsanifar, M. (2024) · Diabetes Obesity and Metabolism · doi:10.1111/dom.15730 · Cited by 44
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“This is evident in Table 10, where Confidence Intervals (CI) and p values were reported as emphasised by [129], and the Hedges’g score( g )was calculated, resulting in a range from small, medium and large effects [128].”
BackgroundMethodPeriprosthetic Joint Infection After Total Knee Arthroplasty With or Without Antibiotic Bone Cement
Leta, T. H., Lie, S. A., Fenstad, A. M., Lygre, S. H. L., Lindberg‐Larsen, M., Pedersen, A. B., W‐Dahl, A., Rolfson, O., Bülow, E., van Steenbergen, L. N., et al. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.12898 · Cited by 37
Nishi, S. K., Kavanagh, M. E., Ramboanga, K., Ayoub-Charette, S., Modol, S., Dias, G. M., Kendall, C. W. C., Sievenpiper, J. L., & Chiavaroli, L. (2024) · eClinicalMedicine · doi:10.1016/j.eclinm.2024.102798 · Cited by 37
“28 To mitigate a unit-of-analysis error, when arms of trials with multiple intervention or control arms were used more than once, the corresponding sample size was divided by the number of times it was used for a calculation of the SE.”
Chen, Y., Li, L., Chen, X., Yan, Q., & Hu, X. (2025) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.70048 · Cited by 40
Fang, B.-B., Lu, F. J.-H., Gill, D. L., Liu, S. H., Chyi, T., & Chen, B. (2021) · Perceptual and Motor Skills · doi:10.1177/00315125211022709 · Cited by 36
“As a preliminary analysis found that included studies had high heterogeneity, we used a random-effects model to estimate the overall effect of heterogeneity (Tufanaru et al., 2015).”
MethodChiavaroli, L., Cheung, A., Ayoub‐Charette, S., Ahmed, A., Lee, D., Au‐Yeung, F., Qi, X., Back, S., McGlynn, N. D., Ha, V., et al. (2023) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2023.01.023 · Cited by 39
A Meta-analysis of the Relations Between Socioeconomic Status and Parenting Practices
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“It was not reasonable to assume that all the studies have the same effect; therefore, we used a random-effect model (Tufanaru et al., 2015).”
Cataract Surgery and Cognitive Benefits in the Older Person
Yeo, B. S. Y., Ong, R. Y. X., Ganasekar, P., Tan, B. K. J., Seow, D. C. C., & Tsai, A. S. H. (2024) · Ophthalmology · doi:10.1016/j.ophtha.2024.02.003 · Cited by 37
Occupational Lead Exposure and Brain Tumors: Systematic Review and Meta-Analysis
Ahn, J., Park, M. Y., Kang, M., Shin, I., An, S., & Kim, H. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17113975 · Cited by 36
“To calculate the pooled odds ratios (ORs), if the studies were heterogeneous both clinically and statistically, we used the random effect model [25].”
MethodYeo, B. S. Y., Koh, J. H., Ng, A. C. W., Loh, S. R. H., See, A., Seow, D. C. C., & Toh, S. T. (2023) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2023.101790 · Cited by 35
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“Also, we compared the random and fixed-effects model, and the decision was made based on the best-fitting model to the data [17].”
MethodPaleolithic Diet—Effect on the Health Status and Performance of Athletes?
Frączek, B., Pięta, A., Burda, A., Mazur-Kurach, P., & Tyrała, F. (2021) · Nutrients · doi:10.3390/nu13031019 · Cited by 41
“Thus, most criteria suggest that a rand [70].”
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Systematic Reviews in Burns Care
Campbell, J. M., Kavanagh, S., Kurmis, R., & Munn, Z. (2016) · Journal of Burn Care & Research · doi:10.1097/bcr.0000000000000409 · Cited by 36
Self-citationSulaiman, S. K., Musa, M. S., Tsiga-Ahmed, F. I., Sulaiman, A. K., & Bako, A. T. (2023) · Nature Human Behaviour · doi:10.1038/s41562-023-01733-3 · Cited by 34
“Using the Mantel–Haenszel method, we calculated the pooled effect estimates (ORs) of each determinant and their 95% CIs using either random-effects or fixed-effects meta-analyses, depending on the degree of heterogeneity across the studies 164,165 , and presented the results as forest plots.”
Arteaga-Henríquez, G., Lugo‐Marín, J., Gisbert, L., Setién-Ramos, I., Martínez‐Gallo, M., Pujol‐Borrell, R., & Ramos‐Quiroga, J. A. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms232214329 · Cited by 34
“Based on the expected between-study differences in sample size and/or recruitment procedures and methods used to determine the levels of assessed markers, random-effects models were used [18].”
MethodEffectiveness of decision aids for smoking cessation in adults: a quantitative systematic review.
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Labrecque, R. M., Viglione, J., & Caudy, M. S. (2022) · Justice Quarterly · doi:10.1080/07418825.2022.2120062 · Cited by 33
“The random model was selected over the fixed model because the intent of this study is to generalize the results beyond the included studies (see Tufanaru et al., 2015).”
Seid, A., Fufa, D. D., Weldeyohannes, M., Tadesse, Z., Fenta, S. L., Bitew, Z., & Dessie, G. (2023) · Food Science & Nutrition · doi:10.1002/fsn3.3388 · Cited by 39
“…dietary patterns are usually affected by geographical settings and socioeconomic factors; the studies included used different dietary assessment methods; and there was an uneven cutoff point for classifying the exposure variable, that is, maternal dietary diversity (Tufanaru et al., 2015).”
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Hu, P., Yan, T., Xiao, B., Shu, H., Sheng, Y., Wu, Y., Shu, L., Lv, S., Ye, M., Gong, Y., et al. (2024) · International Journal of Surgery · doi:10.1097/js9.0000000000001266 · Cited by 38
“We adopt Tufanaru C method to determine synthesis model [25] : when less than fi ve studies, fi xed-effect model (Inverse variance method) is selected to combine data.”
MethodPrevalence and management of pulmonary nodules: a systematic review and meta-analysis
Chen, D., Yang, L., Zhang, W., Shen, J., Schil, P. E. V., Divisi, D., Seetharamu, N., & Gu, J. (2024) · Journal of Thoracic Disease · doi:10.21037/jtd-24-874 · Cited by 33
“Based on the suggestions of a previous article (15), we utilized the random effect model to estimate the overall prevalence, employing the ‘meta’ package in R for data synthesis.”
Wang, H., Luo, P., Liu, S., Liu, Y., Zhang, X., & Li, J. H. (2024) · Journal of Medical Internet Research · doi:10.2196/55576 · Cited by 39
“When the number of included studies was 5 or fewer, the fixed-effects model was applied [40].”
Khalafi, M., Maleki, A. H., Ehsanifar, M., Symonds, M. E., & Rosenkranz, S. K. (2024) · Obesity Reviews · doi:10.1111/obr.13855 · Cited by 36
“It was assumed that heterogeneity was likely for clinical studies, 64 therefore, random effects models were used to minimize heterogeneity effects among included studies.”
Lin, J., Zhang, Y., Zhu, X., Wang, D., & Dai, J. (2018) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2018.1529161 · Cited by 33
“A random-effects model or fixed-effects model was used depending on comprehensive consideration [19].”
MethodMarchetti, C., Fagotti, A., Tombolini, V., Scambia, G., & Felice, F. D. (2020) · Annals of Surgical Oncology · doi:10.1245/s10434-020-09226-7 · Cited by 33
Chueh, T., Hsieh, S., Tsai, Y.-J., Yu, C., Hung, C., Benzing, V., Schmidt, M., Chang, Y., Hillman, C. H., & Hung, T. (2021) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2021.102097 · Cited by 40
Rajwa, P., Pradère, B., Gandaglia, G., van den Bergh, R. C. N., Tsaur, I., Shim, S. R., Yanagisawa, T., Laukhtina, E., Mori, K., Mostafaei, H., et al. (2022) · European Urology · doi:10.1016/j.eururo.2022.03.031 · Cited by 33
Jones, I. A., LoBasso, M., Wier, J. R., Gettleman, B. S., Richardson, M. K., Ratto, C. E., Lieberman, J. R., & Heckmann, N. D. (2024) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000007007 · Cited by 32
Erlich, M. N., Ghidanac, D., Mejía, S. B., Khan, T. A., Chiavaroli, L., Zurbau, A., Ayoub‐Charette, S., Almneni, A., Messina, M. J., Leiter, L. A., et al. (2024) · BMC Medicine · doi:10.1186/s12916-024-03524-7 · Cited by 33
“Fixed effects were used when less than five trials were available for an outcome [26].”
Viscardi, G., Back, S., Ahmed, A., Yang, S., Mejía, S. B., Zurbau, A., Khan, T. A., Selk, A., Messina, M. J., Kendall, C. W. C., et al. (2024) · Advances in Nutrition · doi:10.1016/j.advnut.2024.100327 · Cited by 32
de Rezende, H. A., Melleiro, M. M., & Shimoda, G. T. (2019) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2017-003895 · Cited by 32
“The choice of model (random or fixed effects) and method for meta-analysis will be based on the guidance by Tufanaru et al.(27) Subgroup analyses will be conducted where there is sufficient data to investigate for effectiveness, age group (children, adolescents and adults) and types of intervention.”
MethodWu, Y.-S., Ni, L., Fan, R.-M., & Yao, M. (2019) · World Neurosurgery · doi:10.1016/j.wneu.2019.05.165 · Cited by 32
Steves, S. L., & Scafide, K. N. (2021) · European Journal of Oncology Nursing · doi:10.1016/j.ejon.2021.101981 · Cited by 37
Bahji, A., Bach, P., Danilewitz, M., Crockford, D. N., el‐Guebaly, N., Devoe, D. J. A., & Saitz, R. (2022) · Addiction · doi:10.1111/add.15853 · Cited by 36
Sood, N., Sangari, A., Goyal, A., & Conway, J. A. S. (2022) · Medicine · doi:10.1097/md.0000000000030860 · Cited by 32
“[18,19] Random-effects models were used due to the heterogeneity of study protocols unless included studies numbered fewer than 5, as recommended in the Cochrane Handbook.[20,21] Pooled risk ratios (RR) and standardized mean differences (SMD) were calculated for binary and continuous data respectively.”
MethodAlmaatani, D., Zurbau, A., Khoshnevisan, F., Bandsma, R., Khan, T. A., Sievenpiper, J. L., & van den Heuvel, M. (2022) · Maternal and Child Nutrition · doi:10.1111/mcn.13448 · Cited by 32
“A fixed effects model was used if there were fewer than five studies (Tufanaru et al., 2015).”
MethodPascual‐Morena, C., Cavero‐Redondo, I., Álvarez‐Bueno, C., Jiménez‐López, E., Saz‐Lara, A., Martínez‐García, I., & Martínez‐Vizcaíno, V. (2022) · Developmental Medicine & Child Neurology · doi:10.1111/dmcn.15481 · Cited by 32
Meta-analysis of randomized controlled trials of the effects of probiotics in Parkinson's disease
Chu, C., Yu, L., Li, Y. H., Guo, H., Zhai, Q., Chen, W., & Tian, F. (2023) · Food & Function · doi:10.1039/d2fo03825k · Cited by 34
van de Kar, M. R. D., van Brakel, T. J., Veer, M. V. ’., van Steenbergen, G. J., Daeter, E. J., Crijns, H. J. G. M., van Veghel, D., Dekker, L., & Otterspoor, L. (2024) · European Heart Journal · doi:10.1093/eurheartj/ehae267 · Cited by 32
Pourmoghadam, Z., Abdolmohammadi‐Vahid, S., Pashazadeh, F., Maleki, L. A., Ansari, F., & Yousefi, M. (2019) · Journal of Reproductive Immunology · doi:10.1016/j.jri.2019.103077 · Cited by 31
A systematic review of the effects of probiotic administration in inflammatory arthritis
Lowe, J. R., Briggs, A. M., Whittle, S., & Stephenson, M. (2020) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2020.101207 · Cited by 31
Self-citationRuidiaz-Gómez, K. S., & Higuita‐Gutiérrez, L. F. (2020) · Jornal de Pediatria · doi:10.1016/j.jped.2020.10.013 · Cited by 31
Andreadou, M. T., Katsaras, G. Ν., Talimtzi, P., Doxani, C., Zintzaras, E., & Stefanidis, I. (2021) · European Journal of Pediatrics · doi:10.1007/s00431-021-04187-9 · Cited by 31
“The main analysis, and the subgroup analysis were performed using the random effect model due to the heterogeneity of the studies [31].”
MethodLiang, M., Ahmad, F., & Dickinson, R. (2022) · British Journal of Anaesthesia · doi:10.1016/j.bja.2022.04.016 · Cited by 31
Yan, Q., Zhu, C., Li, L., Li, Y., Chen, Y., & Hu, X. (2024) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2024.104895 · Cited by 30
Mulugeta, H., Sinclair, P. M., & Wilson, A. (2023) · PLoS ONE · doi:10.1371/journal.pone.0283146 · Cited by 33
Fuller, A., Vasek, M., Mariconti, E., & Johnson, S. D. (2023) · Drug and Alcohol Review · doi:10.1111/dar.13716 · Cited by 36
“The latter were calculated using the inverse variance weighted approach and a random effects model [33] which are commonly used in statistical meta-analyses [34,35].”
MethodLim, N. E., Yeo, B. S. Y., Lee, R. S., Lim, J. X., Chan, Y. H., Kandiah, N., Ho, R., Ho, C. S. H., Woo, J., Arai, H., et al. (2024) · Ageing Research Reviews · doi:10.1016/j.arr.2024.102470 · Cited by 31
Yan, Q., Li, X., Chen, Y., Li, L., & Hu, X. (2025) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.12764 · Cited by 30
Using risk and odds ratios to assess effect size for meta‐analysis outcome measures
Alavi, M., Hunt, G. E., Visentin, D. C., Watson, R. A., Thapa, D. K., & Cleary, M. L. (2020) · Journal of Advanced Nursing · doi:10.1111/jan.14528 · Cited by 30
“Quantitative indicators of the magnitude and direction of the effect of any intervention on a respective outcome is called the effect size (Tufanaru et al., 2015).”
InfluentialSantos, E. J. F., Cardoso, D., Neves, H. L., Cunha, M., Rodrígues, M. A., & Apóstolo, J. (2017) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2017-003391 · Cited by 29
Yeo, J. W., Law, M. S. N., Lim, J. C. L., Ng, C. H., Tan, D. J. H., Tay, P. W. L., Syn, N. L. X., Tham, H. Y., Huang, D. Q., Siddiqui, M. S., et al. (2021) · Clinical Transplantation · doi:10.1111/ctr.14520 · Cited by 29
A meta-analysis on immediate effects of attentional focus on motor tasks performance
Nicklas, A., Rein, R., Noël, B., & Klatt, S. (2022) · International Review of Sport and Exercise Psychology · doi:10.1080/1750984x.2022.2062678 · Cited by 36
Maximizing Safety and Optimizing Outcomes of Labiaplasty: A Systematic Review and Meta-Analysis
Escandón, J. M., Duarte‐Bateman, D., Bustos, V. P., Escandón, L., Mantilla‐Rivas, E., Mascaro-Pankova, A., Ciudad, P., Langstein, H. N., & Manrique, O. J. (2022) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000009552 · Cited by 31
Gordon, C. S., Pink, M. A., Rosing, H., & Mizzi, S. (2022) · Educational Research Review · doi:10.1016/j.edurev.2022.100490 · Cited by 56
Jin, L., Liu, X., Guo, B., Han, Z., Wang, Y., Cao, Y., Yang, X., & Shi, J. (2024) · Safety Science · doi:10.1016/j.ssci.2024.106704 · Cited by 28
Logan, A., Freeman, J. A., Pooler, J., Kent, B., Gunn, H., Billings, S., Cork, E., & Marsden, J. F. (2020) · JBI Evidence Synthesis · doi:10.11124/jbisrir-d-18-00005 · Cited by 28
“The choice of random effects model and methods for meta-analysis were based on the guidance by Tufanaru et al.(43) There were insufficient individualized data to conduct subgroup analyses,(39) and insufficient number of studies to generate a funnel plot.”
Methodvan de Kuit, A., Krishnan, R. J., Mallee, W. H., Goedhart, L. M., Lambert, B., Doornberg, J. N., Vervest, T. M. J. S., & Martin, J. E. (2022) · Arthroplasty · doi:10.1186/s42836-021-00110-7 · Cited by 28
“We calculated relative risk (RR) and 95% confidence interval (CI) with a random effects model [10].”
Methodda Silva, R. C. G., Abrunheiro, S. F. S., Cardoso, D., Santos‐Costa, P., Couto, F. C., Agrenha, C., & Apóstolo, J. (2018) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2017-003483 · Cited by 28
“Data synthesis Statistical pooling (meta-analysis) was not performed due to significant differences between interventions, assessed outcomes (clinical heterogeneity) and designs (methodological heterogeneity).(27) Therefore, the findings are presented in narrative form and organized according to the outcomes of intere…”
MethodAichouche, R., Chergui, K. A., Brika, S. K., Mezher, M. E., Musa, A. A., & Laamari, A. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.856234 · Cited by 28
Schizophrenia and Progressive Muscle Relaxation – A systematic review of effectiveness
Melo-Dias, C., Lopes, R., Cardoso, D., Campos, E. B., & Apóstolo, J. (2019) · Heliyon · doi:10.1016/j.heliyon.2019.e01484 · Cited by 28
“Significant differences were found between participants, interventions, outcome measures (clinical heterogeneity) and designs (methodological heterogeneity) (Tufanaru et al., 2015).”
BackgroundPedrani, M., Salfi, G., Merler, S., Testi, I., Cani, M., Turco, F., Trevisi, E., Tortola, L., Treglia, G., Tanna, G. L. D., et al. (2024) · European Urology Oncology · doi:10.1016/j.euo.2024.04.011 · Cited by 27
Casanova‐Rodríguez, D., Ranchal‐Sánchez, A., Rodríguez, R. B., & Jurado‐Castro, J. M. (2025) · European Journal of Pain · doi:10.1002/ejp.4783 · Cited by 39
“Forest plots with mean differences (MD) and 95% confidence intervals (CI) were used to present the results of the meta-analysis, instead of standardised mean difference (SMD), due to the results of the intervention, which could be normalised (C. Andrade 2020; Tufanaru et al. 2015).”
Tarekegn, Z. S., Dejene, H., Addisu, A., & Dagnachew, S. (2020) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0008944 · Cited by 27
“Further, the funnel plot, Egger’s, and Begg’s tests [27] were performed to assess small study effects and publication bias.”
MITCHELL, B. G., Curryer, C., Holliday, E. G., Rickard, C. M., & Fasugba, O. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-046817 · Cited by 27
Fung, J. Y. T., Lim, H., Vongsirimas, N., & Klainin‐Yobas, P. (2022) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x221078490 · Cited by 29
“39 As recommended by the Cochrane Handbook, results should not focus only on statistical signi fi cance or non-signi fi cance using p-value to prevent conclusion deriving from insuf fi cient evidence.”
Method
Metadata
- Authors
- Tufanaru, C., Munn, Z., Stephenson, M., & Aromataris, E.
- Affiliations
- The University of Adelaide (AU)
- Venue
- International Journal of Evidence-Based Healthcare
- Published
- 2015-09
- Volume
- 13
- Issue
- 3
- Pages
- 196-207
- ISSN
- 1744-1595 (ISSN-L)
- 1744-1609
- OpenAlex
- W2180006680
- Cited by
- 1,057
- References
- 62
- Citations by year
- 2026: 77 · 2025: 151 · 2024: 204 · 2023: 167 · 2022: 157 · 2021: 101 · 2020: 65 · 2019: 57 · 2018: 48 · 2017: 22 · 2016: 8
- FWCI
- 4.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Evidence-Based Healthcare (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Keywords
- fixed-effects meta-analysis, random-effects meta-analysis, systematic review methodology, intervention effectiveness, effect size, research design
- MeSH terms
- Humans, Research Design, Review Literature as Topic, Meta-Analysis as Topic, Odds Ratio, Guidelines as Topic, Cross-Over Studies, Evidence-Based Medicine, Observational Studies as Topic
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