The DOI matches its Crossref record; 59 of the 62 references it cites were found in a registry or an index.
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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Chapman, A., Nagle, C., Bick, D., Lindberg, R., Kent, B., Calache, J., & Hutchinson, A. M. (2019) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-019-2351-2 · Cited by 27
Cara, K. C., Beauchesne, A. R., Wallace, T. C., & Chung, M. (2022) · Advances in Nutrition · doi:10.1093/advances/nmab101 · Cited by 26
“Due to heterogeneity in the study designs and health status of study populations, a fixed-effect model meta-analysis was deemed inappropriate, so random-effects model meta-analyses were conducted (34).”
Xiao, J., Zeng, R. W., Lim, W. H., Tan, D. J. H., Yong, J. N., Fu, C. E., Tay, P. W. L., Syn, N. L. X., Ong, C. E. Y., Ong, E. Y. H., et al. (2023) · Liver Transplantation · doi:10.1097/lvt.0000000000000303 · Cited by 27
“[15,16] I 2 values were used to assess statistical heterogeneity, where I 2 values of 25%, 50%, and 75% represented low, moderate, and high degrees of heterogeneity, respectively.”
MethodMeta‐analysis: Prevalence and impact of alcohol abstinence in alcohol‐associated cirrhosis
Lim, W. H., Tay, P. W. L., Ng, C. H., Tan, D. J. H., Ong, C. E. Y., Koh, J. H., Teng, M. L. P., Chee, D., Wong, Z. Y., Kawaguchi, T., et al. (2024) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.17888 · Cited by 27
“31,32”
Ji, X., Guo, X., Soh, K. L., Japar, S., & He, L. (2024) · Nursing and Health Sciences · doi:10.1111/nhs.13113 · Cited by 36
Yeo, B. S. Y., Tan, V. Y. J., Ng, J. H., Tang, J. Z., Sim, B. L. H., Tay, Y. L., Chowdhury, A. R., David, A. P., Jiam, N. T., Kozin, E. D., et al. (2025) · JAMA Otolaryngology–Head & Neck Surgery · doi:10.1001/jamaoto.2025.0056 · Cited by 34
Veritti, D., Sarao, V., Soppelsa, V., & Lanzetta, P. (2021) · Clinical ophthalmology · doi:10.2147/opth.s236423 · Cited by 26
“For the above-mentioned reasons, we believe that a random-effects approach is the best method to be used in our meta-analysis and metaregression.(83) When considering the results with dexamethasone implant, the visual outcomes surprisingly showed a trend to better performance in real-life studies (+1.”
MethodAyoub‐Charette, S., Chiavaroli, L., Liu, Q., Khan, T. A., Zurbau, A., Au‐Yeung, F., Cheung, A., Ahmed, A., Lee, D., Choo, V. L., et al. (2021) · Journal of Nutrition · doi:10.1093/jn/nxab144 · Cited by 28
van der Meulen, M., Najafabadi, A. H. Z., Broersen, L. H. A., Schoones, J. W., Pereira, A. M., van Furth, W. R., Claessen, K. M. J. A., & Biermasz, N. R. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab874 · Cited by 26
“A random-effects model was used if at least 5 studies could be included in the analysis of a specific outcome, and a fixed-effects model was used if less than 5 studies could be analyzed, since between-study variance cannot be estimated reliably in that case (25).”
MethodPark, J., Kim, S. Y., & Lee, K. (2022) · Scientific Reports · doi:10.1038/s41598-022-07762-8 · Cited by 26
Guo, X., Su, W., Wang, H., Li, N., Song, Q., Liang, Q., Sun, C., Liang, M., Zhou, Z., Song, E. J., et al. (2022) · International Journal of Environmental Health Research · doi:10.1080/09603123.2022.2066070 · Cited by 28
“Random effects model was used in all analyses as recent evidence suggests that it can provide more robust outcome measures in comparison to the fixed effects model (Tufanaru et al. 2015).”
MethodFuge, T. G., Tsourtos, G., & Miller, E. R. (2022) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2022.07.037 · Cited by 26
Ma, C., Li, M., Li, R., & Wu, C. (2022) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2022.104837 · Cited by 26
Hochheim, M., Ramm, P., & Amelung, V. E. (2022) · Pain Practice · doi:10.1111/papr.13198 · Cited by 29
“This model did not only account for the statistical heterogeneity of the included studies, but allowed for generalization beyond these studies.(40,41) Subgroup analyses were performed to investigate different delivery modes (individual versus group setting), length of follow- up (short, medium, long- term, very long t…”
ResultKoh, J. H., Lim, C. Y. J., Yam, K.-M., Yeo, B. S. Y., Ng, A. C. W., Loh, S. R. H., Hsu, P. P., Gooley, J. J., Tan, C. S., & Toh, S. T. (2024) · Clinical Kidney Journal · doi:10.1093/ckj/sfae279 · Cited by 25
Zhang, Z., Lim, J. X., Wen, D. W., Wong, C. P., Lim, W. E. H., & Chia, G. S. (2024) · Neurosurgical Review · doi:10.1007/s10143-024-03107-3 · Cited by 25
“The exception was if the outcome was investigated in less than five studies, in which case the fixed-effects model was used[50], though in these cases we also tested the random-effects model and found negligible differences between the two.”
Liu, K., Zhao, W. D., Li, C., Tian, Y., Wang, L., Zhong, J., Xu, Y., Wang, Y., Wang, L., & Wang, H. (2024) · Scientific Reports · doi:10.1038/s41598-024-83802-9 · Cited by 32
Rinse-free hand wash for reducing absenteeism among preschool and school children
Munn, Z., Tufănaru, C., Lockwood, C. S., Stern, C., McAneney, H., & Barker, T. H. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012566.pub2 · Cited by 24
Self-citationJalilpiran, Y., Jayedi, A., Djafarian, K., & Shab‐Bidar, S. (2020) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2020.1863906 · Cited by 25
Li, J., Liu, S., Li, Z., Han, X., & Que, L. (2021) · Frontiers in Oncology · doi:10.3389/fonc.2021.683825 · Cited by 30
“The random-effects model was used in all analyses, irrespective of heterogeneity, to account for differences among study populations, treatment regimens, and local practices (37, 41).”
MethodLeemans, L., Polli, A., Nijs, J., Wideman, T. H., den Bandt, H. L., & Beckwée, D. (2022) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2022.10527 · Cited by 25
Effect of alpha-adrenoceptor antagonists on sexual function. A systematic review and meta-analysis
Bapir, R., Bhatti, K. H., Eliwa, A., García‐Perdomo, H. A., Gherabi, N., Hennessey, D. B., Magri, V., Mourmouris, P., Ouattara, A., Perletti, G., et al. (2022) · Archivio Italiano di Urologia e Andrologia · doi:10.4081/aiua.2022.2.252 · Cited by 25
Bruyneel, A.-V., Reinmann, A., Gafner, S. C., Sandoz, J.-D., & Duclos, N. C. (2023) · Gait & Posture · doi:10.1016/j.gaitpost.2023.01.009 · Cited by 25
Cai, Y., Ren, X., Wang, J., Ma, B., & Chen, O. (2023) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2023.04.014 · Cited by 30
What Counteracts Problematic Social Media Use in Adolescence? A Cross-National Observational Study
Lahti, H., Kulmala, M., Hietajärvi, L., Lyyra, N., Kleszczewska, D. W., Boniel‐Nissim, M., Fürstová, J., van den Eijnden, R. J. J. M., Sudeck, G., & Paakkari, L. T. (2023) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2023.07.026 · Cited by 25
Cheah, M. C. C., Crane, H., & George, J. (2025) · Hepatology International · doi:10.1007/s12072-025-10801-x · Cited by 30
“Further, heterogeneity is anticipated in global epidemiological studies and has been well reported [30].”
Remington, J., & Winters, K. P. (2019) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2017-003842 · Cited by 24
Analysis of heterogeneity in a systematic review using meta-regression technique
Lo, K., Stephenson, M., & Lockwood, C. S. (2019) · International Journal of Evidence-Based Healthcare · doi:10.1097/xeb.0000000000000163 · Cited by 24
“If included studies for review are clinically and methodologically heterogeneous, it may not be suitable to report a meta-analysis, or to limit reporting to the identification and exploration of the heterogeneity.(1,3) To estimate the level of heterogeneity in meta-analysis, a commonly applied statistical test for het…”
BackgroundSelf-citationPascual‐Morena, C., Cavero‐Redondo, I., Martínez‐Vizcaíno, V., Sequí‐Domínguez, I., Fernández‐Bravo‐Rodrigo, J., & Jiménez‐López, E. (2022) · Journal of Neuromuscular Diseases · doi:10.3233/jnd-221586 · Cited by 24
“, BMD or DMD), a random effects meta-analysis was conducted [20, 21].”
BackgroundWong, Z. Y., Koh, J. H., Muthiah, M. D., Koh, B., Ong, E. Y. H., Ong, C. E. Y., Ou, K. Q., Lim, W. H., Tan, D. J. H., Chee, D., et al. (2023) · Digestive Diseases and Sciences · doi:10.1007/s10620-023-08150-6 · Cited by 24
“A random-effect model was used in all analyses regardless of heterogeneity measures as evidence has demonstrated more robust effect estimates with random-effect compared to fixed-effect models [22, 23].”
Barnes, S., MacDonald, I., Rahmaty, Z., de Goumoëns, V., Grandjean, C., Jaques, C., & Ramelet, A. (2024) · JBI Evidence Synthesis · doi:10.11124/jbies-23-00034 · Cited by 24
Tai chi improves balance performance in healthy older adults: a systematic review and meta-analysis
Cui, Z., Xiong, J., Li, Z., & Yang, C. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1443168 · Cited by 26
“Random effect models were utilized to calculate the weighted mean difference (WMD) and the 95% confidence interval (CI) of TC exercise based on the Mean ± SD in each balance performance outcome (37).”
Fixed-effect versus random-effect model in meta-analysis: How to decide?
Maitra, S. (2025) · Indian Journal of Anaesthesia · doi:10.4103/ija.ija_1203_24 · Cited by 24
“[7,13] In the real world, results from a meta-analysis are almost used outside the patient population, and the fixed-effect meta-analysis is not appropriate.”
Workplace bullying and risk of burnout in nurses: a systematic review protocol
Purpora, C., Cooper, A., Sharifi, C., & Lieggi, M. (2019) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-d-19-00019 · Cited by 23
Quality of Life Changes in Acute Coronary Syndromes Patients: A Systematic Review and Meta-Analysis
Kaambwa, B., Gesesew, H., Horsfall, M., & Chew, D. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17186889 · Cited by 20
“If the number of studies that reported QoL was less than five (small), fixed effect model was considered irrespective of the degree of heterogeneity [36,37].”
BackgroundQi, X., Chiavaroli, L., Lee, D., Ayoub‐Charette, S., Khan, T. A., Au‐Yeung, F., Ahmed, A., Cheung, A., Liu, Q., Mejía, S. B., et al. (2022) · Nutrients · doi:10.3390/nu14193986 · Cited by 25
“A fixed effects model was used when <5 trial comparisons were available [29].”
MethodKimmie‐Dhansay, F., & Bhayat, A. (2022) · BMC Oral Health · doi:10.1186/s12903-022-02489-4 · Cited by 23
“In addition the random /fixed effects model was chosen based on the Tufanaru article [27] which states that a minimum of 5 articles be used to run a random effects meta-analysis.”
MethodPsaroulaki, E., Katsaras, G. Ν., Samartzi, P., Chatziravdeli, V., Psaroulaki, D., Oikonomou, E. K., & Tsitsani, P. (2023) · European Journal of Pediatrics · doi:10.1007/s00431-023-04843-2 · Cited by 25
“The main analysis, along with the pre-specified sub-group analyses, was done using the random effect model, due to the intrinsic heterogeneity of the included studies [16].”
MethodFixed-effect Versus Random-effects Models for Meta-analyses: Random-effects Models
Halme, A. L. E., McAlpine, K., & Martini, A. (2023) · European Urology Focus · doi:10.1016/j.euf.2023.10.023 · Cited by 23
Effect of honey on cardiometabolic risk factors: a systematic review and meta-analysis
Ahmed, A., Tul‐Noor, Z., Lee, D., Bajwah, S., Ahmed, Z., Zafar, S., Syeda, M., Jamil, F., Qureshi, F. A., Zia, F., et al. (2022) · Nutrition Reviews · doi:10.1093/nutrit/nuac086 · Cited by 22
“A fixed-effects model was used when fewer than 5 trial comparisons were available.(20) Paired analyses were”
MethodAgbangla, N. F., Séba, M.-P., Bunlon, F., Toulotte, C., & Fraser, S. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20136226 · Cited by 32
“To test the effects of the different studies, 100% of the meta-analyses used the random-effect model, which is a statistical model used when the authors’ objective is to generalize the results by estimating the mean of the effect size distribution [43,44].”
MethodZhang, Z. X., Lai, J., Shen, L., & Krishna, L. (2024) · British Journal of Sports Medicine · doi:10.1136/bjsports-2023-107717 · Cited by 22
Alharbi, R. J., Lewis, V. J., Shrestha, S., & Miller, C. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-047439 · Cited by 22
Chan, J., Oo, S., Butt, S. P., Benedetto, U., Caputo, M., Angelini, G. D., & Vohra, H. A. (2022) · Perfusion · doi:10.1177/02676591221075522 · Cited by 22
“Fixed effect meta-analysis model was chosen based on the small number of studies included and no generalisation inference.(11) A league table and rankogram was also generated for analysis.”
MethodNonpharmacological interventions for agitation in the adult intensive care unit: A systematic review
Adams, A. M. N., Chamberlain, D. J., Grønkjær, M., Thorup, C. B., & Conroy, T. (2022) · Australian Critical Care · doi:10.1016/j.aucc.2022.02.005 · Cited by 24
Irwinda, R., Hiksas, R., Lokeswara, A. W., & Wibowo, N. (2022) · Women s Health · doi:10.1177/17455057221111066 · Cited by 22
Munhoz, O. L., Morais, B. X., dos Santos, W. M., de Paula, C. C., & Magnago, T. S. B. D. S. (2022) · Revista Latino-Americana de Enfermagem · doi:10.1590/1518-8345.6219.3708 · Cited by 25
Pascual‐Morena, C., Cavero‐Redondo, I., Sequí‐Domínguez, I., Rodríguez‐Gutiérrez, E., Visier‐Alfonso, M. E., & Martínez‐Vizcaíno, V. (2023) · Neuropathology and Applied Neurobiology · doi:10.1111/nan.12914 · Cited by 22
“Meta-analyses with the DerSimonian and Laird random-effects method [22, 23] were conducted when two or more studies determined the same outcome in the same population.”
MethodHyndman, K., Thomas, R. E., Schira, R., Bradley, J., Chachula, K. M., Patterson, S. K., & Compton, S. M. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16214158 · Cited by 24
“We used a random-effects model [74,88,89] to calculate effect sizes expressed as standardized mean differences (for continuous data), odds ratios (for categorical data) and their 95% confidence intervals.”
MethodZheng, M., Luo, Y., Lin, W., Khoja, A. A., He, Q., Yang, S., Zhao, X., & Hu, P. (2020) · Systematic Reviews · doi:10.1186/s13643-020-01386-7 · Cited by 22
Ma, S., Han, T., Sun, C., Cheng, C., Zhang, H., Qu, G., Bhan, C., Yang, H., Guo, Z., Yan, Y., et al. (2021) · International Journal of Colorectal Disease · doi:10.1007/s00384-021-03889-8 · Cited by 22
“In order to promote the results of our study beyond the included studies, random effects model is the most appropriate meta-analysis model [19].”
ResultManagement of dental caries lesions in patients with disabilities: Update of a systematic review
Molina, G. F., Zar, M. R., Dougall, A., & McGrath, C. P. J. (2022) · Frontiers in Oral Health · doi:10.3389/froh.2022.980048 · Cited by 21
“Fixed effect model was applied if the total number of studies included in meta analysis was less than six studies (11).”
MethodVentilation devices for neonatal resuscitation at birth: A systematic review and meta-analysis
Tribolet, S., Hennuy, N., & Rigo, V. (2023) · Resuscitation · doi:10.1016/j.resuscitation.2022.109681 · Cited by 21
Efficacy of Cryoablation on Chronic Rhinitis Management: A Systematic Review and Meta-Analysis
Young, K., Bulosan, H., Kejriwal, S., Liang, J. Z., Wu, A. W., Tang, D. M., Birkeland, A. C., & Steele, T. O. (2023) · American Journal of Rhinology and Allergy · doi:10.1177/19458924231152331 · Cited by 21
“A random-effects model was chosen over a fixed effect due to our investigation including ≥5 studies.(16) The same process was done for the 3 studies that included RQLQ scores at baseline and 3-month follow-up.”
MethodLuo, L. Y., Lee, J., Li, K. Y., Leung, Y. Y., & Li, D. T. S. (2023) · Diagnostics · doi:10.3390/diagnostics13040653 · Cited by 21
“, less than five) were eligible to be included in each analysis [17,18].”
BackgroundLim, T. W., Tan, S. K., Li, K. Y., & Burrow, M. F. (2023) · Journal of Evidence Based Dental Practice · doi:10.1016/j.jebdp.2023.101911 · Cited by 24
Tian, H., Yang, C., Song, T., Zhou, K., Wen, L., Tian, Y., Tang, L., Xu, W., & Zhang, X. (2023) · Reviews in Medical Virology · doi:10.1002/rmv.2473 · Cited by 20
Talukdar, J. R., Cooper, M. A., Lyutvyn, L., Zeraatkar, D., Ali, R., Berbrier, R., Janes, S., Ha, V., Darling, P. B., Xue, M., et al. (2024) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2023.10.030 · Cited by 22
Mostafaei, H., Janisch, F., Mori, K., Quhal, F., Pradère, B., Hajebrahimi, S., Roehrborn, C. G., & Shariat, S. F. (2021) · European Urology Focus · doi:10.1016/j.euf.2021.02.005 · Cited by 21
Kleinveld, D. J. B., van Amstel, R. B. E., Wirtz, M. R., Geeraedts, L. M. G., Goslings, J. C., Hollmann, M. W., & Juffermans, N. P. (2021) · Transfusion · doi:10.1111/trf.16455 · Cited by 21
“Thereby, it can be postulated that the effect size of platelet dose on TIC is similar between studies.(27) A p value of .”
Gao, Y., Wang, N., Zhang, L., & Liu, N. (2023) · Journal of Clinical Nursing · doi:10.1111/jocn.16726 · Cited by 20
Reynolds, K., Chimoriya, R., Chandio, N., Tracey, D., Pradhan, A., Fahey, P. P., Stormon, N., & Arora, A. (2023) · BMC Oral Health · doi:10.1186/s12903-023-03445-6 · Cited by 23
“[82].”
Kiss, I., Kühn, M., Hrušák, K., & Büchler, T. (2022) · ESMO Open · doi:10.1016/j.esmoop.2022.100474 · Cited by 22
“For the purpose of comparing pooled data within the type of immunotherapy, the OR and CI were derived from a random effect model as recommended by Tufanaru et al.(11) For three-arm studies with two immunotherapy arms and a non-immunotherapy control arm, we proceeded according to guidance published by Rücker et al.”
MethodWright, M., Cortina‐Borja, M., Knowles, R. L., & Urquhart, D. S. (2023) · European Respiratory Review · doi:10.1183/16000617.0133-2023 · Cited by 20
“Random effects models were fitted owing to the relatively large number of studies included in the meta-analysis and because the included studies were heterogeneous in terms of the study population and design [10].”
MethodKazeminasab, F., Baharlooie, M., Karimi, B., Mokhtari, K., Rosenkranz, S. K., & Santos, H. O. (2023) · Nutrition Reviews · doi:10.1093/nutrit/nuad155 · Cited by 21
Liu, Z., Jiang, Z., Zhang, L., Xue, X., Zhao, C., Xu, Y., Zhang, W., Lin, L., & Chen, Z. (2024) · Frontiers in Microbiology · doi:10.3389/fmicb.2023.1307960 · Cited by 20
Amin, Z., El-naggar, A. K., Offiah, I., Dua, A., & Freeman, R. M. (2024) · International Urogynecology Journal · doi:10.1007/s00192-024-05756-w · Cited by 20
“The over-all estimates were obtained using random-effects models [17].”
Sikaroudi, M. K., Soltani, S., Ghoreishy, S. M., Ebrahimi, Z., Shidfar, F., & Dehnad, A. (2024) · Food & Function · doi:10.1039/d3fo03717g · Cited by 27
Pascual‐Morena, C., Cavero‐Redondo, I., Saz‐Lara, A., Sequí‐Domínguez, I., Lucerón‐Lucas‐Torres, M., & Martínez‐Vizcaíno, V. (2021) · Pharmaceuticals · doi:10.3390/ph14080798 · Cited by 20
“When two or more HRs for the LoA associated with a specific genetic variant and their 95% CI were available, a fixed-effects meta-analysis was performed [31].”
BackgroundYoon, J.-H., Kim, E. H., Park, S. B., Lee, J. Y., & Yoon, S. W. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.753140 · Cited by 19
“If the number of studies included in the comparison was more than four and had significant heterogeneity (>50%), a random-effects model was used; otherwise, a fixed-effects model was used (Tufanaru et al., 2015).”
MethodLawrence, C., Waechter, S., & Alsanius, B. W. (2022) · Frontiers in Microbiology · doi:10.3389/fmicb.2022.867865 · Cited by 19
Vasavada, A. M., Singh, P., Firdaus, A., Sundaram, D. M., Patel, M., Singh, G., Palanisamy, L., Ansari, S. A., Thummala, S., & Pandya, H. (2023) · Cureus · doi:10.7759/cureus.35070 · Cited by 19
“But our rationale to use the random-effects model was not just based on heterogeneity (the reason reviewers suggest we use fixed-effects) but the overall criteria tested and supported by the literature published in the International Journal of Evidence-Based Healthcare [12].”
MethodBahji, A., Kaur, S., Devoe, D. J. A., & Patten, S. B. (2022) · The Canadian Journal of Addiction · doi:10.1097/cxa.0000000000000154 · Cited by 20
Investigation of follicular helper T cells, as a novel player, in preeclampsia
Heydarlou, H., Eghabl‐Fard, S., Ahmadi, M., Maleki, L. A., Dolati, S., Movassaghpour, A. A., Jadidi‐Niaragh, F., Danaii, S., lafout, F. M., Talebi, M., et al. (2018) · Journal of Cellular Biochemistry · doi:10.1002/jcb.27666 · Cited by 19
“It was also observed that Tfh population in peripheral blood of immune infertile patients was significantly higher than healthy pregnant women.(19) In a novel study in 2017, Xiaorui Luan et al(20) revealed that Tfh significantly increased in recurrent spontaneous abortion (RSA) patients.”
ResultAdugna, C., Wang, K., Du, J., & Li, C. (2024) · Poultry Science · doi:10.1016/j.psj.2024.104412 · Cited by 18
Frailty as a predictor of mortality in the oldest old: A systematic review and meta‐analysis
Tan, J. A., Koh, J. H., Merchant, R. A., & Tan, L. F. (2024) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.15025 · Cited by 18
“21 When three or more studies were available, 95% prediction intervals (PIs) were computed to estimate the potential range of true effect sizes across individual studies, given that the 95% con fi dence interval accounts only for the uncertainty of the mean effect size and not for the uncertainty of…”
Cardiovascular diseases and risk of dementia in the general population
Luo, J. M., Rasmussen, I. J., Nordestgaard, B. G., Tybjærg‐Hansen, A., Thomassen, J. Q., & Frikke‐Schmidt, R. (2025) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwaf129 · Cited by 20
Hall, K. C., & Robinson, J. C. (2019) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2017-003881 · Cited by 18
de Rezende, H. A., Vitorio, A. M. F., Morais, A. S., Garzin, A. C. A., Nicole, A. G., Quadrado, E. R. S., Lourenção, D. C. D. A., & Martins, M. S. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-058888 · Cited by 23
“Statistical analyses will be performed using a random effects model 36 to allow generalisation.”
MethodAppetite-regulating hormones in bipolar disorder: A systematic review and meta-analysis
Misiak, B., Kowalski, K. E., Stańczykiewicz, B., Bartoli, F., Carrà, G., Samochowiec, J., Samochowiec, A., & Frydecka, D. (2022) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2022.101013 · Cited by 19
“…estimator were used to pool effect size estimates calculated as Hedges’ g. Random-effects models are recommended if included studies are characterized by methodological heterogeneity, and thus we did not deem as reasonable to assume that they could share a common effect (Tufanaru et al., 2015).”
BackgroundMethodAssies, R., Snik, I., Kumwenda, M., Chimalizeni, Y. F., Langton, J., van Woensel, J. B. M., Doctor, A., & Calis, J. C. J. (2022) · Journal of Tropical Pediatrics · doi:10.1093/tropej/fmac053 · Cited by 18
“We applied the Freeman-Tukey double arcsine transformation to stabilize data and random effect models (DerSimonain-Laird estimator) to calculate the overall pooled mortality assuming heterogeneity [17, 18].”
MethodThe optimal dose of oral tranexamic acid in melasma: A network meta-analysis
Wang, W.-J., Wu, T., Tu, Y., Kuo, K., Tsai, C., & Chie, W. (2022) · Indian Journal of Dermatology Venereology and Leprology · doi:10.25259/ijdvl_530_2021 · Cited by 18
Bae, K., Lamoury, G., Carroll, S., Morgia, M., Lim, S. H.-S., Baron-Hay, S. E., Shin, I., Park, S.-J., & Oh, B. (2022) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2022.103898 · Cited by 21
Paris, T., Daly, R. M., Abbott, G., Sood, S., Freer, C. L., Ryan, M. C., & George, E. S. (2024) · Advances in Nutrition · doi:10.1016/j.advnut.2024.100169 · Cited by 18
“We used random-effects models given that there was no common fi xed parameter, studies estimated different parameters, and the interventions were different [39].”
MethodMeyer, D. M., Gjika, E., Raab, R., Michel, S., & Hauner, H. (2024) · Obesity Reviews · doi:10.1111/obr.13679 · Cited by 26
“20 As is recommended for meta-analyses with few studies and higher heterogeneity, we used the Hartung – Knapp – Sidik – Jonkman (HKSJ) method for random-effects meta-analyses, rather than the Der-Simonian and Laird approach.”
MethodAssaye, A. M., Wiechula, R., Schultz, T., & Feo, R. (2018) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2017-003707 · Cited by 20
Clinical Relevance of Epidural Steroid Injections on Lumbosacral Radicular Syndrome-related Synptoms
de Bruijn, T. M., de Groot, I. B., Miedema, H. S., Haumann, J., & Ostelo, R. (2021) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000943 · Cited by 21
“2 (17-83) VAS (0-100) for pain‡ Post-treatment: I 30.”
Does aspirin have an effect on risk of death in patients with COVID-19? A meta-analysis
Ma, S., Su, W., Sun, C., Lowe, S., Zhou, Z., Liu, H., Qu, G., Xia, W., Xie, P., Wu, B., et al. (2022) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-022-03356-5 · Cited by 18
“In order to promote the results of our study beyond the included studies, random effects model is the most appropriate meta-analysis model [29].”
Xin-Ru, H. U., Liao, G., Wang, J., Ye, Y., Chen, X., Bai, L., Shi, F., Liu, K., & Peng, Y. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.124.034915 · Cited by 18
School climate and cyberbullying victimization: A meta-analysis
Li, S., Gong, N., Lin, Y., Huang, F., Zhang, S., & Yu, G. (2024) · Children and Youth Services Review · doi:10.1016/j.childyouth.2024.108064 · Cited by 27
Wang, Y., Li, M., Jiang, Y., & Ji, Q. (2025) · Frontiers in Neuroscience · doi:10.3389/fnins.2024.1530987 · Cited by 18
Billany, R. E., BISHOP, N. C., Castle, E. M., Graham-Brown, M. P. M., Greenwood, S. A., Lightfoot, C. J., & Wilkinson, T. J. (2025) · Renal Failure · doi:10.1080/0886022x.2025.2480246 · Cited by 17
“Although an I 2 value ≥40% is conventionally used to indicate moderate heterogeneity in the literature, we also took into account the magnitude of effects and strength of evidence (e.g., p value from χ 2 test) in our interpretation [55].”
Meta‐Analysis: Utilisation of Hepatocellular Carcinoma Surveillance
Tang, N. S. Y., Gunalan, S. Z., Ong, C. E. Y., Koh, B., Tham, E. K. J., Lim, R. Y., Tan, D. J. H., Syn, N. L. X., Ng, C. H., Muthiah, M. D., et al. (2025) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.70403 · Cited by 18
“A random-effects model was employed in all analyses irrespective of all measures of heterogeneity, based on evidence indicating that random-effects models yield more reliable effect estimates compared to fixed effect models [22, 23].”
Duan, L., Zhang, S., Yan, Q., Chen, Y., Su, Y., & Hu, X. (2026) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.70103 · Cited by 17
Anagnostis, P. G., Florou, P., Bosdou, J. Κ., Grimbizis, G. F., Iakovou, I. P., Kolibianakis, E. M., & Goulis, D. G. (2021) · Maturitas · doi:10.1016/j.maturitas.2021.04.002 · Cited by 17
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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