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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Pakkam, M., Orscelik, A., Musmar, B., Tolba, H., Ghozy, S. A., Şenol, Y. C., Bilgin, C., Nayak, S. S., Kadirvel, R., Brinjikji, W., et al. (2024) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2024.107716 · Cited by 13
Teixeira, T., Godoi, A., Romeiro, P. H. C. L., Novaes, J. V. L. C., Faria, F. M. D. F., Pereira, S. F., & Lamounier, R. N. (2024) · Acta Diabetologica · doi:10.1007/s00592-024-02284-3 · Cited by 11
“We also employed a random-effects model in the analysis, which ensures that the differences in technologies used by different trials are accounted for [32].”
Holtgrewe, L., Johnson, A. B., Nyhan, K., Boffa, J., Shenoi, S., Karat, A. S., Davis, J. L., & Charalambous, S. (2024) · PLOS Global Public Health · doi:10.1371/journal.pgph.0003753 · Cited by 11
Goh, C. C., Gan, X., & Klainin‐Yobas, P. (2024) · Seminars in Oncology Nursing · doi:10.1016/j.soncn.2024.151796 · Cited by 12
de Souza, M. H. G., Al‐Sharif, L., Diaz, I., Khalil, S. M., Lv, X., Mantovani, A., & Villela‐Nogueira, C. A. (2025) · Liver International · doi:10.1111/liv.70029 · Cited by 11
“A random effects model was used in all analyses, irrespective of heterogeneity [14].”
Prevalence of Autoimmune Gastritis Worldwide: A Systematic Review and Meta‐Analysis
Li, M., Huang, Y., Xiao, L., & Lü, H. (2025) · Helicobacter · doi:10.1111/hel.70065 · Cited by 12
“A random-effects model was applied to all analyses, regardless of heterogeneity levels, as evidence suggests that random-effects models produce more robust effect estimates compared to fixed-effects models [29].”
Reduction in erosive tooth wear using stannous fluoride-containing dentifrices: a meta-analysis
Trentin, G. A., Mendes, L. T., da Silva, B. S., Casagrande, L., de Araújo, F. B., & Lenzi, T. L. (2021) · Brazilian Oral Research · doi:10.1590/1807-3107bor-2021.vol35.0114 · Cited by 11
Brooks, R., & Bannigan, K. (2018) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2017-003612 · Cited by 11
“It is likely that a random effects model will be used and heterogeneity will be assessed statistically using the standard chi-square test, however selection of the meta-analysis model will be guided by Tufanaru et al.(31) If statistical pooling is not be possible the findings will be presented in narrative form includ…”
Methods of estimating the pooled effect size under meta-analysis: A comparative appraisal
Pathak, M., Dwivedi, S. N., Thakur, B., & Vishnubhatla, S. (2019) · Clinical Epidemiology and Global Health · doi:10.1016/j.cegh.2019.05.004 · Cited by 11
Ting, D. S. J., Henein, C., Said, D. G., & Dua, H. S. (2019) · JBI Evidence Synthesis · doi:10.11124/jbisrir-d-19-00148 · Cited by 11
Hang, J., Naseri, C., Francis‐Coad, J., Jacques, A., Waldron, N., Knuckey, R., & Hill, A. (2021) · International Journal of Older People Nursing · doi:10.1111/opn.12408 · Cited by 11
Wang, M. K., Heo, R., Meyre, P. B., Park, L., Blum, S., McIntyre, W. F., Belley‐Côté, E. P., Birchenough, L., Vuong, K., Healey, J. S., et al. (2022) · CJC Open · doi:10.1016/j.cjco.2022.06.003 · Cited by 11
“As only a small number of studies were included in each of the main analyses, we chose to use fixed-effects models.(8) Between-study statistical heterogeneity was quantified using the I(2) value, and heterogeneity was considered to be important when I(2) was greater than 30%.”
MethodWang, B., Gould, R. L., Kumar, P., Pikett, L., Thompson, B., Gonzalez, S. C., & Bamiou, D.-E. (2022) · American Journal of Audiology · doi:10.1044/2022_aja-21-00162 · Cited by 10
van den Dikkenberg, M., Luurssen‐Masurel, N., Kuijper, T. M., Kok, M. R., Hazes, J. M. W., de Jong, P. H. P., Barreto, D. L., & Weel, A. E. A. M. (2022) · Arthritis Care & Research · doi:10.1002/acr.24965 · Cited by 10
Xin, W., Xu, D., Dou, Z., Jacques, A., Umbella, J., & Hill, A. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-062992 · Cited by 10
Huang, D. Q., Chan, K. E., Tan, C., Zeng, R. W., Koh, B., Ong, E. Y. H., Ong, C. C. H., Ong, C. E. Y., Tan, D. J. H., Lim, W. H., et al. (2023) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.17516 · Cited by 10
Qiu, H., Chuang, K.-J., Fan, Y., Chang, T.-P., Chuang, H., Wong, E. L., Bai, C., & Ho, K. (2023) · Ecotoxicology and Environmental Safety · doi:10.1016/j.ecoenv.2023.115239 · Cited by 10
Tang, A. S. P., Tan, C., Lim, W. H., Ng, C. H., Tan, D. J. H., Zeng, R. W., Xiao, J., Ong, E. Y. H., Cho, E. E. L., Chung, C. H., et al. (2023) · Transplantation · doi:10.1097/tp.0000000000004840 · Cited by 11
“26,27 Quality Assessment and Risk of Bias Quality assessment of included articles was conducted with the Joanna Briggs Institute (JBI) Critical Appraisal Tool.”
MethodChyi, T., Lu, F. J. H., Hsieh, Y.-C., Hsu, Y.-W., Gill, D. L., & Fang, B.-B. (2023) · Perceptual and Motor Skills · doi:10.1177/00315125231216329 · Cited by 13
“We used a Q-test to examine whether the true effect size (ES) varied between studies when a random effect was applied (i.e., heterogeneity, Tufanaru et al., 2015).”
MethodHaematologic biomarkers and survival in gallbladder cancer: a systematic review and meta-analysis
Velasco, R., Tan, H. N., & Juan, M. D. S. (2024) · ecancermedicalscience · doi:10.3332/ecancer.2024.1660 · Cited by 10
Jiang, H., liu, Y., Guo, H., Liu, Z., & Li, Z. (2024) · BMC Cardiovascular Disorders · doi:10.1186/s12872-024-03903-1 · Cited by 10
“Considering that we included only five studies and there were significant differences in study sizes among them, we opted for a fixed-effects model [15, 16].”
BackgroundMcArthur, C., Alizadehsaravi, N., Affoo, R. H., Cooke, K., Douglas, N., Earl, M., Flynn, T., Ghanouni, P., Hunter, S. W., Kalu, M. E., et al. (2024) · JBI Evidence Synthesis · doi:10.11124/jbies-23-00431 · Cited by 10
Zhao, F.-Y., Li, L., Xu, P., Zhang, W., Kennedy, G. A., Zheng, Z., Wang, Y., Yue, L.-P., Ho, J. Y. S., Fu, Q.-Q., et al. (2024) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s484387 · Cited by 10
“Following the recommendations of Tufanaru et al, 22 the random-effects model was the default, as it generalizes findings beyond the included studies.”
MethodLi, L., Zhu, C., Yan, Q., Li, J., Chen, Y., & Hu, X. (2025) · Journal of Clinical Nursing · doi:10.1111/jocn.17700 · Cited by 13
Baker, E., Chanamolu, M. C., Nieri, C. A., White, S. F., Brandt, J., & Gillespie, M. B. (2025) · OTO Open · doi:10.1002/oto2.70067 · Cited by 14
“14 Therefore, this model was used to meaningfully estimate the proportion of patients with changes in either tongue volume or tongue fat composition with respect to patients with OSA versus patients without OSA.”
Carletti, F., Maggi, M., Fazekas, T., Rajwa, P., Nicoletti, R., Olivier, J., Preißer, F., Soeterik, T. F. W., Giganti, F., Martini, A., et al. (2025) · European Radiology · doi:10.1007/s00330-025-11603-3 · Cited by 11
“Based on the likely heterogeneity of the studies, we utilized random-effect models for our calculations [24, 25].”
Stavinoha, P. L., Olsthoorn, I. M., Swartz, M. C., Nowakowski, S., Wells, S. J., Hicklen, R., Sheikh, I. N., & Jang, H. J. (2021) · Systematic Reviews · doi:10.1186/s13643-021-01724-3 · Cited by 11
“Statistical analyses will be performed using random effects [42].”
MethodReynolds, K., Chandio, N., Chimoriya, R., & Arora, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192113758 · Cited by 11
Effect of nanoparticles on gouty arthritis: a systematic review and meta-analysis
Zhu, R., Niu, Y., Zhou, W., Wang, S., Mao, J., Guo, Y., Lei, Y., Xiong, X., Li, Y., & Guo, L. (2023) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-023-06186-3 · Cited by 10
“Because the heterogeneity of this study is high, and compared with fixed-effects model, the random-effects model is more conservative [30].”
BackgroundVasilica, A.-M., Winsor, A., Chari, A., Scott, R. C., Baldeweg, T., & Tisdall, M. M. (2023) · Epilepsy Research · doi:10.1016/j.eplepsyres.2023.107132 · Cited by 10
“All meta analyses employed a random effects model for two reasons (Bell and Sander, 2001) there were more than five studies and (Rugg-Gunn et al., 2020) homogeneity between the studies could not be assumed due to difference in measurement tools (Tufanaru et al., 2015).”
Yang, Y., Wang, Y., Gao, T., Reyila, A., Liu, J., Liu, J., & Han, H. (2023) · Biological Research For Nursing · doi:10.1177/10998004231171587 · Cited by 12
“According to the recommendations of Tufanaru et al. (2015) and Cochrane Handbook for Systematic Reviews of Interventions (Chapter 10) (Available from www.training.cochrane.org/handbook), both the random-effect model and the fixed-effect model were applied.”
Liu, Q., Chiavaroli, L., Ayoub‐Charette, S., Ahmed, A., Khan, T. A., Au‐Yeung, F., Lee, D., Cheung, A., Zurbau, A., Choo, V. L., et al. (2023) · PLoS ONE · doi:10.1371/journal.pone.0264802 · Cited by 11
“A fixed effects model was used when 5 trial comparisons were available [41].”
Fixed-effect Versus Random-effects Models for Meta-analyses: Fixed-effect Models
Mostafaei, H., Ghojazadeh, M., & Hajebrahimi, S. (2023) · European Urology Focus · doi:10.1016/j.euf.2023.09.015 · Cited by 10
Chongxi, R., Jianna, S., Kong, L., & Wang, H. (2023) · European Journal of Surgical Oncology · doi:10.1016/j.ejso.2023.107308 · Cited by 11
Chan, A. J., Sambrook, P. J., Munn, Z., & Boase, S. (2019) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2017-003875 · Cited by 10
Self-citationLapierre, A., Arbour, C., Maheu‐Cadotte, M., Radermaker, M., Fontaine, G., & Lavoie, P. (2021) · JBI Evidence Synthesis · doi:10.11124/jbies-20-00213 · Cited by 10
“All meta-analyses will be performed using an inverse variance approach with random effects models.(24) Results of all meta-analyses will be expressed with 95% confidence intervals and presented as either raw or standardized mean differences, depending on whether study authors use identical assessment tools.”
MethodParhizkar, F., Parhizkar, Z., Mojahedi, M., Chakari-Khiavi, A., Salehnia, F., Chakari-Khiavi, F., Danaii, S., & Yousefi, M. (2022) · Gene Reports · doi:10.1016/j.genrep.2021.101490 · Cited by 10
Yang, J., Wang, W., Luo, Y. L., Huang, S., & Fu, Z. (2022) · Techniques in Coloproctology · doi:10.1007/s10151-021-02564-y · Cited by 10
“Therefore, the fixed-effects model was adopted for the meta-analysis [26].”
MethodLim, W. H., Lin, S. Y., Ng, C. H., Tan, D. J. H., Xiao, J., Yong, J. N., Tay, P. W. L., Syn, N. L. X., Chin, Y. H., Chan, K. E., et al. (2022) · HepatoBiliary Surgery and Nutrition · doi:10.21037/hbsn-21-520 · Cited by 10
“All analyses were conducted in random effects regardless of heterogeneity measures as it has been shown to be produce more robust estimates compared to the fixed effects models (31).”
ResultMusa, A. A. R., Sethi, S., Poirier, B., Oliver, K. J., & Jensen, E. D. (2023) · International Journal of Paediatric Dentistry · doi:10.1111/ipd.13069 · Cited by 9
Issaka, A., Paradies, Y., Cameron, A. J., & Stevenson, C. (2023) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2023.06.011 · Cited by 9
Haara, S. R. T., de Rezende, H. A., & Wang, C. (2024) · Sultan Qaboos University medical journal · doi:10.18295/squmj.1.2024.007 · Cited by 10
Kasem, R. A., Cunningham, C. M., Elawady, S. S., Sowlat, M., Babool, S., Hulou, S., Hubbard, Z., Orscelik, A., Musmar, B., & Spiotta, A. M. (2024) · Neurosurgical Review · doi:10.1007/s10143-024-03149-7 · Cited by 9
“Given the presence of methodological heterogeneity among the included studies, we employed a random effects model to amalgamate the data [55].”
Huber, N., Meester, M., Sassu, E. L., Waller, E. S. L., Krumova-Valcheva, G. L., Aprea, G., D’Angelantonio, D., Zoche-Golob, V., Scattolini, S., Marriott, E., et al. (2024) · Frontiers in Veterinary Science · doi:10.3389/fvets.2024.1494870 · Cited by 9
“We established that a minimum of five observations were needed for performing a meta-analysis, in line with the established methodology, as suggested, for example, refer to references (24, 25).”
Kuehnle, R. A., Tchelebi, L. T., Ludmir, E. B., Escorcia, F. E., Shrestha, S., Sanford, N. N., Court, C. M., Ryckman, J. M., Arora, S. P., Lehrer, E. J., et al. (2025) · Cancer · doi:10.1002/cncr.35720 · Cited by 9
“19,25 As indicated in Figure 4, the trial by Comito et al. 11 had a low ROB, whereas the studies by Romero et al. and Bush et al. had some concern for bias.”
Fong, K. Y., Lim, E. J., Wong, H. C., Tay, K. J., Gan, V. H. L., Ho, H. S. S., Yuen, J. S. P., & Chen, K. S.-M. (2025) · Urologic Oncology Seminars and Original Investigations · doi:10.1016/j.urolonc.2025.01.012 · Cited by 9
Weinberg, B. J., Roos, R., & van Aswegen, H. (2022) · South African Journal of Physiotherapy · doi:10.4102/sajp.v78i1.1764 · Cited by 9
“Bundled care or MDT clinical pathway includes and organises transdisciplinary interventions as a means of optimising compliance to recommended treatment guidelines (Unsworth et al. 2015).”
BackgroundMethodInfluentialMeng, S., Kong, X., Nan, J., Yang, X., Li, J., Yang, S., Zhao, L., & Jin, Z. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1145412 · Cited by 9
“1, and the number of included studies of observed clinical outcomes was less than 5, then the fixed-effects model was used (7).”
MethodMa, S., Xia, W., Wu, B., Sun, C., Jiang, Y., Liu, H., Lowe, S., Zhou, Z., Xie, P., Gao, J., et al. (2023) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-023-03556-7 · Cited by 9
“In order to promote the results of our study beyond the included studies, random-effects model is the most appropriate meta-analysis model [38].”
ResultAn assessment of the impact of developmental dysplasia of the hip on patients’ wellbeing
Franco, H., Saxby, N. E., Corlew, D. S., Perry, D. C., & Pigeolet, M. (2023) · Bone & Joint Open · doi:10.1302/2633-1462.43.bjo-2022-0154.r1 · Cited by 9
Pathak, M., Dwivedi, S. N., & Thakur, B. (2019) · Clinical Epidemiology and Global Health · doi:10.1016/j.cegh.2019.06.011 · Cited by 9
Como medir e explorar a heterogeneidade de uma meta-análise: Estratégias metodológicas fundamentais
Santos, E. J. F., Cardoso, D., & Apóstolo, J. (2022) · Revista de Enfermagem Referência · doi:10.12707/rv21077 · Cited by 8
Khalafi, M., Symonds, M. E., Ghasemi, F., Rosenkranz, S. K., Rohani, H., & Sakhaei, M. H. (2023) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2023.110741 · Cited by 10
Huhtala, S., Palomaa, A.-K., Tuomikoski, A., & Pölkki, T. (2023) · JBI Evidence Synthesis · doi:10.11124/jbies-22-00057 · Cited by 8
“Statistical analyses will be conducted using fixed-effects or random-effects models for meta-analysis based on guidance from Tufanaru et al. 30 A funnel plot (Egger test, Begg test, Harbord test) will be generated to assess publication bias if 10 or more studies are included in a meta-analysis.”
MethodOumer, A. (2024) · PLoS ONE · doi:10.1371/journal.pone.0299538 · Cited by 8
“Given the anticipated heterogeneity, statistical analyses will be performed using a random-effects model for meta-analysis [34].”
MethodBiosynthetic mesh in hernia repair: A systematic review and meta-analysis
Al-Bustami, I. S., Clements, T., Ferguson, D. M., Harmouch, A., Olavarria, O. A., & Holihan, J. L. (2024) · International journal of abdominal wall and hernia surgery · doi:10.4103/ijawhs.ijawhs_99_23 · Cited by 8
Liu, Y., Zhang, Q., & Huang, X. (2024) · Prostate Cancer and Prostatic Diseases · doi:10.1038/s41391-024-00871-7 · Cited by 8
Nann, S. D., Clark, M. S., Kovoor, J. G., Jog, S., & Aromataris, E. (2024) · JBI Evidence Synthesis · doi:10.11124/jbies-24-00110 · Cited by 8
“Statistical analysis was performed using a random-effects model 42 and using the DerSimonian-Laird inverse variance statistical method.”
Self-citationPascual‐Morena, C., Martínez‐Vizcaíno, V., Cavero‐Redondo, I., Álvarez‐Bueno, C., Lucerón‐Lucas‐Torres, M., Saz‐Lara, A., & Martínez‐García, I. (2024) · Acta Neuropsychiatrica · doi:10.1017/neu.2024.27 · Cited by 8
“…when there were more than 10 studies and/or the heterogeneity was statistically significant, while fixed-effects meta-analyses were performed when there were fewer than 10 studies and the heterogeneity was not statistically significant (DerSimonian and Laird, 1986; Tufanaru et al ., 2015).”
Sijberden, J. P., Escribano, M. S. A., Kasai, M., Ferretti, C., Cesaro, P., Bnà, C., Zaniboni, A., Siriwardena, A. K., Tanis, P. J., & Hilal, M. A. (2024) · HPB · doi:10.1016/j.hpb.2024.10.010 · Cited by 8
Thoracic irrigation for traumatic hemothorax: A systematic review and meta-analysis
Lyons, N. B., Collie, B. L., Cobler-Lichter, M. D., Delamater, J. M., Shagabayeva, L., Bustillos, L. T., Proctor, K. G., Valenzuela, J. Y., Meizoso, J. P., & Namias, N. (2024) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000004479 · Cited by 8
Faggiano, A., Gherbesi, E., Giordano, C., Gamberini, G., Vicenzi, M., Cuspidi, C., Carugo, S., Cipolla, C. M., & Cardinale, D. M. (2024) · Cancers · doi:10.3390/cancers16223883 · Cited by 8
Chen, Y., Chen, X., Li, L., Li, Y., Yan, Q., & Hu, X. (2024) · Cancer Nursing · doi:10.1097/ncc.0000000000001430 · Cited by 11
Acupuncture for atopic dermatitis: a systematic review and meta-analysis
Liang, S., Huang, K., Zhang, L., Li, M., Gu, H.-H., & Chen, N. (2024) · BMJ Open · doi:10.1136/bmjopen-2024-084788 · Cited by 8
“No patient or public involvement.”
Belyani, S., Kazeminasab, F., Niazi, M., Bagheri, R., Hesari, M. M., Rosenkranz, S. K., CAMERA, D. M., & Dutheil, F. (2025) · Current Developments in Nutrition · doi:10.1016/j.cdnut.2025.104560 · Cited by 9
“The fi ndings considered the possibility of heterogeneity of both clinical and/or methodological factors that could have in fl uenced the outcomes [31].”
Martin, J. R., Clark, N. C., Newman, K., Fyock-Martin, M. B., & Abel, M. G. (2025) · Ergonomics · doi:10.1080/00140139.2025.2471542 · Cited by 8
“In addition to the heterogeneity statistics, the goals of the statistical inference and number of studies were considered when determining whether to use a fixed-or random-effects meta-analysis model (Tufanaru et al. 2015).”
Sood, S., Sylivris, A., Sualeheen, A., Scott, D., Tan, S., Villani, A. M., Baguley, B. J., Abbott, G., Kiss, N. K., Daly, R. M., et al. (2025) · Clinical Nutrition · doi:10.1016/j.clnu.2025.06.019 · Cited by 13
Jia, Q., Zhang, B., Wang, H., & Zheng, W. (2025) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-025-09218-2 · Cited by 8
“A random effects model was used to estimate the overall effect size, as a high degree of quantitative variation in the I² statistic between studies [31].”
Kirsty, C.-W., Hickson, M., & Sumner, J. (2022) · Nutrition and Health · doi:10.1177/02601060221080240 · Cited by 9
Nguyen, V. P., Collins, A. E., Hickey, J. P., Pfeifer, J. A., & Kalisch, B. E. (2023) · Brain Sciences · doi:10.3390/brainsci13010153 · Cited by 8
“An interpretation of (I2) was as follows: I2 < 60% is regarded as moderate I2 from 50% to 90% is considered substantial I2 from 75% to 100% is considerable Evaluation of publication bias across studies was visually quantified using funnel plots and Egger’s test [21].”
MethodInfluentialKhalafi, M., Symonds, M. E., Sakhaei, M. H., & Ghasemi, F. (2023) · PLoS ONE · doi:10.1371/journal.pone.0292734 · Cited by 8
“Random-effects models were used because heterogeneity was expected, given methodological and clinical variability, and may have affected the results [17].”
MethodIndrayani, N. L. D., Kao, C., Suyasa, I. G. P. D., Mudiyanselage, S. P. K., Chang, J., & Wang, C. (2024) · Journal of Safety Research · doi:10.1016/j.jsr.2024.01.001 · Cited by 8
Macdonald, M., Gallant, A. J., Weeks, L. E., Delahunty-Pike, A., Moody, E., Iduye, D., Rothfus, M., States, C., Martin-Misener, R., Ignaczak, M., et al. (2024) · JBI Evidence Synthesis · doi:10.11124/jbies-23-00021 · Cited by 11
“40 Subgroup analysis was not conducted where there were insufficient data to investigate, such as a comparison of specific types of technologies (eg, low, medium, high), age, cognition, or length of intervention.”
The Endocannabinoid System in Alzheimer's Disease: A Network Meta‐Analysis
Liu, Y., Xing, H., Zhang, Y., & Song, Y. (2024) · Journal of Neuroscience Research · doi:10.1002/jnr.25380 · Cited by 9
“Sensitivity analyses were performed to detect potential heterogeneity sources and the robustness of the findings, ensuring the reliability of the results (Tufanaru et al. 2015).”
Koh, J. H., Lim, C. Y. J., Tan, L. T. P., Sia, C., Poh, K. K., Sharma, V. K., Yeo, L. L. L., Ho, A. F. W., Wu, T. Y., Kong, W. K. F., et al. (2024) · Journal of Stroke · doi:10.5853/jos.2024.01284 · Cited by 8
“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% CI only accounts for the uncertainty of the mean effect size, but not the uncertainty of inter-study variance.”
Morris, A., Bonanno, L., & Bennett, M. J. (2018) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2017-003670 · Cited by 8
Sekhar, V., Ao, J., Iqbal, I. Z., Ooi, E. H., & Munn, Z. (2019) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2017-003972 · Cited by 8
Self-citationPostlicensure herpes zoster vaccine effectiveness: systematic review protocol
Mbinta, J. F., Nguyen, B. P., Awuni, P. M. A., Eme, P. E., & Simpson, C. R. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-040964 · Cited by 8
Brink, N. B., Constantinou, D., & Torres, G. (2023) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000004370 · Cited by 8
Jones, I. A., Talehakimi, A., Murphy, L. S.-L., Wang, J. C., Piple, A. S., Christ, A. B., & Heckmann, N. D. (2023) · Arthroplasty Today · doi:10.1016/j.artd.2023.101097 · Cited by 8
“Statistical analyses were performed using inverse variance with random effects [20].”
MethodD’Amore, C., Reid, J. C., Chan, M., Fan, S., Huang, A., Louie, J., Tran, A., Chauvin, S., & Beauchamp, M. (2021) · JBI Evidence Synthesis · doi:10.11124/jbies-21-00072 · Cited by 7
Incidence of kidney cancer after liver transplantation: a meta-analysis
Zhou, Q., Chen, J., Pan, W., Chen, Y., Wen, L., & Liu, K. (2020) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0000000000001747 · Cited by 8
Logo, D. D., Enuameh, Y., Adjei, G., Singh, A., Nakua, E. K., Dassah, E. T., Oppong, F. B., & Owusu‐Dabo, E. (2022) · Systematic Reviews · doi:10.1186/s13643-022-02127-8 · Cited by 7
“Statistical analyses will be performed using a randomeffects model [21].”
MethodZhu, G., Wang, M., & Kong, F. (2024) · Headache The Journal of Head and Face Pain · doi:10.1111/head.14711 · Cited by 7
“The fixed-effect model was used when I 2 was 50% or fewer than five studies were included in the pooled analysis, 32 as applied and recommended by recent literature.”
MethodHusain, M. O., Jones, B., Arshad, U., Ameis, S. H., Mirfallah, G., Schifani, C., Rodak, T., Aiken, M., Shafique, M. S., Ahmed, F., et al. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05788-y · Cited by 9
“The difference in SV2A binding between individuals with psychosis spectrum and healthy controls, as quantified by volume of distribution (V T ) (i.e., the ratio of the radiotracer concentration in the target tissue region to what is in the arterial plasma) [65], was the main outcome [66].”
BackgroundAssociation of Abnormal Body Weight and Allergic Rhinitis—A Systematic Review and Meta‐Analysis
Yeo, B. S. Y., Guan, E., Ng, K. J., Lim, Y. S., Goh, R. T. H., Liu, X., Phua, C. Q., Tay, K., Png, L. H., Xu, S., et al. (2024) · Clinical & Experimental Allergy · doi:10.1111/cea.14604 · Cited by 7
“We used a random-effects model to combine the maximally adjusted ORs from each included study [21].”
Liu, Y., Zhang, B., Montayre, J., Koduah, A. O., & Leung, A. Y. M. (2025) · Journal of Advanced Nursing · doi:10.1111/jan.16558 · Cited by 8
“…for analysis due to the heterogeneity of interventions and dosages used across the included studies, it was not feasible to assume clinical homogeneity, and subgroup analysis was conducted to identify the heterogeneity sources in SoC which had over two studies each subgroup (Tufanaru et al. 2015).”
Effectiveness of Green Space in Improving Mental Health: A Review
Baskaran, S., Azis, S. S. A., Rahman, N. H. A., & Aziz, N. (2025) · International Journal of Built Environment and Sustainability · doi:10.11113/ijbes.v12.n1.1369 · Cited by 10
Efficacy and safety of pharmacological treatments in inclusion body myositis: a systematic review
Santos, E. J. F., Farisoğulları, B., Yapp, N., Townsley, H., Sousa, P., & Machado, P. (2025) · RMD Open · doi:10.1136/rmdopen-2024-005176 · Cited by 7
Ali, A. S., Arumugam, A., Gururaj, S., Sardesai, S., & Senthil Kumaran, D. (2025) · Virtual Reality · doi:10.1007/s10055-025-01155-8 · Cited by 8
Wang, W., Xu, J., Fujimoto, T., Pouleur, A., Vancraeynest, D., Wang, J.-G., Zen, K., Stoenoiu, M. S., & Persu, A. (2025) · Hypertension Research · doi:10.1038/s41440-025-02248-2 · Cited by 7
“A random-effects model was used for all analyses regardless of heterogeneity measures, since evidence has shown more robust effect estimates with random-effects models compared to fi xed-effects models [17, 18].”
Kazeminasab, F., Sharafifard, F., Kerchi, A. B., Bagheri, R., Carteri, R. B., Kirwan, R., Santos, H. O., & Dutheil, F. (2025) · Nutrients · doi:10.3390/nu17121992 · Cited by 13
“The findings were synthesized using random-effects models to account for potential clinical and methodological heterogeneity that may have influenced the outcomes [30].”
Kazeminasab, F., Mohebinejad, M., Mahboobi, M. H., Nojoumi, M., Belyani, S., Bagheri, R., & Dutheil, F. (2025) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2025.2528534 · Cited by 11
“Results were pooled using random-effects models, based on the assumption that heterogeneity was likely from a clinical perspective, and may have affected the findings [52].”
Effects of resveratrol on postmenopausal women: a systematic review and meta-analysis
Wu, W., Meng, T., Jin, F., Li, J., Huang, J., Guo, Z., Yu, M., & Zhou, Y. (2025) · Frontiers in Pharmacology · doi:10.3389/fphar.2025.1588284 · Cited by 7
An Introduction to Systematic Reviews and Meta-Analyses
Rao, S. C. (2023) · APIK Journal of Internal Medicine · doi:10.4103/ajim.ajim_36_23 · Cited by 8
Yu, Y., Pan, D., Bai, R., Luo, J., Tan, Y., Duan, W., & Shi, D. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1197161 · Cited by 7
“The results of treatment effects were combined with a Mantel– Haenzel fixed-effect model or DerSimonian–Laird random-effects model depending on the heterogeneity among studies and presented as risk ratios (RRs) with 95% confidence intervals (CIs) (13).”
MethodNkemjika, S., Tokede, O., Okosun, I. S., Jadotte, Y. T., & Pigott, T. (2023) · Cancer Epidemiology · doi:10.1016/j.canep.2023.102409 · Cited by 7
Lu, Y., Lu, D., Zhang, H., Li, H., Yu, B., Zhang, Y., Hu, H., & Sheng, H.-F. (2024) · Frontiers in Immunology · doi:10.3389/fimmu.2024.1297454 · Cited by 7
Gao, Y., Wang, N., Liu, Y., & Liu, N. (2024) · Geriatric Nursing · doi:10.1016/j.gerinurse.2024.04.010 · Cited by 7
Lim, T. W., Li, K. Y., Burrow, M. F., & McGrath, C. P. J. (2024) · BMC Oral Health · doi:10.1186/s12903-024-04814-5 · Cited by 10
“…meta-analysis was preferred in this review because of the high heterogeneity caused by the great variations of the study designs among the included studies, the intention to generalize the results beyond the included studies, and the number of the included studies was more than five [34].”
Background
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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