Systematic Review: Why sources of heterogeneity in meta-analysis should be investigated
Open accessAbstract
Although meta-analysis is now well established as a method of reviewing evidence, an uncritical use of the technique can be very misleading. One common problem is the failure to investigate appropriately the sources of heterogeneity, in particular the clinical differences between the studies included. This paper distinguishes between the concepts of clinical and statistical heterogeneity and exemplifies the importance of investigating heterogeneity by using published meta-analyses of epidemiological studies of serum cholesterol concentration and clinical trials of its reduction. Although not without some dangers of speculative conclusions, prompted by overzealous inspection of the data to hand, a sensible investigation of sources of heterogeneity should increase both the scientific and the clinical relevance of the results of meta-analyses.
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Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552 · see citing works
Practical Statistics for Medical Research.
Walter, S., & Altman, D. G. (1992) · Biometrics · doi:10.2307/2532320 · Cited by 11,665 · see citing works
Practical Statistics for Medical Research
Altman, D. G. (1990) · doi:10.1201/9780429258589 · Cited by 10,668 · see citing works
Practical Statistics for Medical Research.
Bartko, J. J., & Altman, D. G. (1992) · Journal of the American Statistical Association · doi:10.2307/2290246 · Cited by 4,834 · see citing works
Altman, R., Carreras, L., Díaz, R. S., Figueroa, E. B., Paolasso, E., Parodi, J. C., Cade, J. F., Donnan, G. A., Eadie, M. J., Gavaghan, T. P., et al. (1994) · Cited by 3,322 · see citing works
Publication bias in clinical research
Easterbrook, P. J., Gopalan, R., Berlin, J. A., & Matthews, D. R. (1991) · The Lancet · doi:10.1016/0140-6736(91)90201-y · Cited by 3,109 · see citing works
Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy
Early Breast Cancer Trialist's Collaborative Group (1992) · The Lancet · doi:10.1016/0140-6736(92)90997-h · Cited by 2,191 · see citing works
Law, M., Wald, N., & Thompson, S. (1994) · British medical journal · doi:10.1136/bmj.308.6925.367 · Cited by 1,306 · see citing works
Yusuf, S. (1991) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1991.03470010097038 · Cited by 1,014 · see citing works
A consumer's guide to subgroup analyses
Oxman, A. D., & Guyatt, G. H. (1992) · Annals of Internal Medicine · doi:10.7326/0003-4819-116-1-78 · Cited by 914 · see citing works
Meta-analysis of the literature or of individual patient data: is there a difference?
Stewart, L. A., & Parmar, M. (1993) · The Lancet · doi:10.1016/0140-6736(93)93004-k · Cited by 771 · see citing works
A general parametric approach to the meta‐analysis of randomized clinical trials
Whitehead, A., & Whitehead, J. (1991) · Statistics in Medicine · doi:10.1002/sim.4780101105 · Cited by 750 · see citing works
Grantham-McGregor, S. M., Powell, C. A., Walker, S. P., & Himes, J. H. (1991) · The Lancet · doi:10.1016/0140-6736(91)90001-6 · Cited by 685 · see citing works
A note on graphical presentation of estimated odds ratios from several clinical trials
Galbraith, R. F. (1988) · Statistics in Medicine · doi:10.1002/sim.4780070807 · Cited by 663 · see citing works
Meta-analysis: State-of-the-Science
Dickersin, K., & Berlin, J. A. (1992) · Epidemiologic Reviews · doi:10.1093/oxfordjournals.epirev.a036084 · Cited by 502 · see citing works
Thompson, S. G., & Pocock, S. (1991) · The Lancet · doi:10.1016/0140-6736(91)91975-z · Cited by 489 · see citing works
Cholesterol lowering and mortality: the importance of considering initial level of risk.
Smith, G., Song, F., & Sheldon, T. (1993) · British medical journal · doi:10.1136/bmj.306.6889.1367 · Cited by 447 · see citing works
Peto, R. (1987) · Statistics in Medicine · doi:10.1002/sim.4780060306 · Cited by 409 · see citing works
Cholesterol and heart disease in older persons and women review of an NHLBI workshop
Manolio, T. A., Pearson, T. A., WENGER, N. K., Barrett-Connor, E. L., Payne, G. H., & Harlan, W. R. (1992) · Annals of Epidemiology · doi:10.1016/1047-2797(92)90051-q · Cited by 353 · see citing works
Prevention of First Bleeding in Cirrhosis
Pagliaro, L., D’Amico, G., Sørensen, T. I. A., Lebrec, D., Burroughs, A. K., Morabito, A., Tinè, F., Politi, F., & Traina, M. (1992) · Annals of Internal Medicine · doi:10.7326/0003-4819-117-1-59 · Cited by 318 · see citing works
Cholesterol lowering trials in coronary heart disease: Frequency of citation and outcome.
Ravnskov, U. (1992) · BMJ · doi:10.1136/bmj.305.6844.15 · Cited by 313 · see citing works
Low serum cholesterol and the risk of cancer: an analysis of the published prospective studies
Law, M. R., & Thompson, S. G. (1991) · Cancer Causes & Control · doi:10.1007/bf00052142 · Cited by 119 · see citing works
Controversies in meta-analysis: the case of the trials of serum cholesterol reduction
Thompson, S. G. (1993) · Statistical Methods in Medical Research · doi:10.1177/096228029300200205 · Cited by 118 · see citing works
Shipley, M. J., Pocock, S., & Marmot, M. G. (1991) · BMJ · doi:10.1136/bmj.303.6794.89 · Cited by 114 · see citing works
Inter‐study differences: How should they influence the interpretation and analysis of results?
Bailey, K. R. (1987) · Statistics in Medicine · doi:10.1002/sim.4780060327 · Cited by 108 · see citing works
Senn, S. J., & Brand, R. (1994) · Statistics in Medicine · doi:10.1002/sim.4780130310 · Cited by 91 · see citing works
Brand, R., & Kragt, H. (1992) · Statistics in Medicine · doi:10.1002/sim.4780111605 · Cited by 64 · see citing works
Systemic Treatment of Early Breast Cancer by Hormonal, Cytotoxic, or Immune Therapy
&NA; (1992) · Obstetrical & Gynecological Survey · doi:10.1097/00006254-199206000-00018 · Cited by 54 · see citing works
The Impact of Stopping Rules on Heterogeneity of Results in Overviews of Clinical Trials
Hughes, M. D., Freedman, L. S., & Pocock, S. (1992) · Biometrics · doi:10.2307/2532737 · Cited by 35 · see citing works
Chalmers, I., Stewart, L., Girling, D. J., Parmar, M. B., & Machin, D. (1991) · The Lancet · doi:10.1016/0140-6736(91)92771-s · Cited by 34 · see citing works
Flagged first, then by citations
1 of the 32 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Moher, D., Cook, D. J., Eastwood, S., Olkin, I., Rennie, D., & Stroup, D. F. (1999) · The Lancet · doi:10.1016/s0140-6736(99)04149-5 · Cited by 4,826 · see citing works
Systematic reviews in the social sciences: a practical guide
(2006) · Choice Reviews Online · doi:10.5860/choice.43-5664 · Cited by 4,074 · see citing works
Systematic reviews: CRD's guidance for undertaking reviews in health care
Tacconelli, E. (2010) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(10)70065-7 · Cited by 3,237 · see citing works
How should meta‐regression analyses be undertaken and interpreted?
Thompson, S. G., & Higgins, J. P. T. (2002) · Statistics in Medicine · doi:10.1002/sim.1187 · Cited by 3,026 · see citing works
Interpretation of random effects meta-analyses
Riley, R. D., Higgins, J. P. T., & Deeks, J. J. (2011) · BMJ · doi:10.1136/bmj.d549 · Cited by 2,884 · see citing works
Moher, D., Schulz, K. F., & Altman, D. G. (2001) · BMC Medical Research Methodology · doi:10.1186/1471-2288-1-2 · Cited by 2,755 · see citing works
A Re-Evaluation of Random-Effects Meta-Analysis
Higgins, J. P. T., Thompson, S. G., & Spiegelhalter, D. J. (2009) · Journal of the Royal Statistical Society Series A: Statistics in Society · doi:10.1111/j.1467-985x.2008.00552.x · Cited by 2,569 · see citing works
“Keywords: Meta-analysis; Prediction; Random-effects models; Systematic reviews”
BackgroundSystematic Review and Meta-analysis
Garg, A. X., Hackam, D. G., & Tonelli, M. A. (2008) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.01430307 · Cited by 2,251 · see citing works
Writing narrative literature reviews for peer-reviewed journals: secrets of the trade
Green, B. N., Johnson, C. D., & Adams, A. (2006) · Journal of Chiropractic Medicine · doi:10.1016/s0899-3467(07)60142-6 · Cited by 2,224 · see citing works
Deeks, J. J., Altman, D. G., & Bradburn, M. J. (2001) · Systematic Reviews in Health Care · doi:10.1002/9780470693926.ch15 · Cited by 2,163 · see citing works
Socioeconomic inequalities in depression: a meta-analysis
Lorant, V. (2003) · American Journal of Epidemiology · doi:10.1093/aje/kwf182 · Cited by 2,603 · see citing works
Advanced methods in meta‐analysis: multivariate approach and meta‐regression
van Houwelingen, H. C., Arends, L. R., & Stijnen, T. (2002) · Statistics in Medicine · doi:10.1002/sim.1040 · Cited by 1,574 · see citing works
Rutledge, T., Reis, V. A., Linke, S. E., Greenberg, B. H., & Mills, P. J. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.06.055 · Cited by 1,513 · see citing works
Controlling the risk of spurious findings from meta-regression
Higgins, J. P. T., & Thompson, S. G. (2004) · Statistics in Medicine · doi:10.1002/sim.1752 · Cited by 1,267 · see citing works
Long-term mental health of war-refugees: a systematic literature review
Bogic, M., Njoku, A., & Priebe, S. (2015) · BMC International Health and Human Rights · doi:10.1186/s12914-015-0064-9 · Cited by 1,166 · see citing works
Guidelines for systematic review in Conservation and environmental management
PULLIN, A. S., & STEWART, G. B. (2006) · Conservation Biology · doi:10.1111/j.1523-1739.2006.00485.x · Cited by 1,137 · see citing works
White, I. R., Barrett, J. K., Jackson, D., & Higgins, J. P. T. (2012) · Research Synthesis Methods · doi:10.1002/jrsm.1045 · Cited by 1,114 · see citing works
Patsopoulos, N. A., Εvangelou, Ε., & Ioannidis, J. P. A. (2008) · International Journal of Epidemiology · doi:10.1093/ije/dyn065 · Cited by 1,147 · see citing works
Conducting systematic reviews of diagnostic studies: didactic guidelines
Devillé, W. L. J. M., Buntinx, F., Bouter, L. M., Montori, V. M., de Vet, H. C. W., van der Windt, D., & Bezemer, P. D. (2002) · BMC Medical Research Methodology · doi:10.1186/1471-2288-2-9 · Cited by 954 · see citing works
Much ado about nothing: a comparison of the performance of meta-analytical methods with rare events
Bradburn, M. J., Deeks, J. J., Berlin, J. A., & Russell Localio, A. (2007) · Statistics in Medicine · doi:10.1002/sim.2528 · Cited by 938 · see citing works
Systems to rate the strength of scientific evidence.
West, S. L., King, V., Carey, T. S., Lohr, K. N., Mckoy, N. A., Sutton, S. F., & Lux, L. J. (2002) · PubMed Central · Cited by 873 · see citing works
The Interpretation of Random-Effects Meta-Analysis in Decision Models
Ades, A. E., Lu, G., & Higgins, J. P. T. (2005) · Medical Decision Making · doi:10.1177/0272989x05282643 · Cited by 861 · see citing works
Alveolar bone dimensional changes of post‐extraction sockets in humans: a systematic review
van der Weijden, G. A., Dell'Acqua, F., & Slot, D. E. (2009) · Journal Of Clinical Periodontology · doi:10.1111/j.1600-051x.2009.01482.x · Cited by 858 · see citing works
Manea, L., Gilbody, S., & McMillan, D. (2015) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2014.09.009 · Cited by 795 · see citing works
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2002) · Journal of Health Services Research & Policy · doi:10.1258/1355819021927674 · Cited by 755 · see citing works
Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children
Goldenberg, J. Z., Ma, S. S., Saxton, J. D., Martzen, M. R., Vandvik, P. O., Thorlund, K., Guyatt, G. H., & Johnston, B. C. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006095.pub3 · Cited by 741 · see citing works
Effectiveness of acute postoperative pain management: I. Evidence from published data
Dolin, S. J., Cashman, J. N., & Bland, J. M. (2002) · British Journal of Anaesthesia · doi:10.1093/bja/89.3.409 · Cited by 737 · see citing works
League Tables and Their Limitations: Statistical Issues in Comparisons of Institutional Performance
Goldstein, H., & Spiegelhalter, D. J. (1996) · Journal of the Royal Statistical Society. Series A (Statistics in Society) · doi:10.2307/2983325 · Cited by 1,069 · see citing works
Guidance on the conduct of narrative synthesis in sytematic reviews
Popay, J., Roberts, H. M., Sowden, A. J., Petticrew, M. P., Arai, L., Rodgers, M., & Britten, N. (2006) · Cited by 690 · see citing works
Stuck, A. E., Egger, M., Hammer, A., Minder, C. E., & Beck, J. C. (2002) · JAMA · doi:10.1001/jama.287.8.1022 · Cited by 675 · see citing works
McClintock, K., Hall, S., & Oliver, C. (2003) · Journal of Intellectual Disability Research · doi:10.1046/j.1365-2788.2003.00517.x · Cited by 675 · see citing works
Jansen, J. P., & Naci, H. (2013) · BMC Medicine · doi:10.1186/1741-7015-11-159 · Cited by 656 · see citing works
Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease
Troosters, T., Casaburi, R. H., Gosselink, R., & Decramer, M. (2005) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200408-1109so · Cited by 644 · see citing works
Evidence on the long-term effects of breastfeeding SYSTEMATIC REVIEWS AND META-ANALYSES
Horta, B. L. (2007) · Cited by 636 · see citing works
A method for meta-analysis of molecular association studies
Thakkinstian, A., McElduff, P., D’Este, C. A., Duffy, D. L., & Attia, J. (2004) · Statistics in Medicine · doi:10.1002/sim.2010 · Cited by 615 · see citing works
Traditional reviews, meta-analyses and pooled analyses in epidemiology
Blettner, M. (1999) · International Journal of Epidemiology · doi:10.1093/ije/28.1.1 · Cited by 591 · see citing works
Recent developments in meta‐analysis
Sutton, A. J., & Higgins, J. P. T. (2007) · Statistics in Medicine · doi:10.1002/sim.2934 · Cited by 583 · see citing works
Factors predisposing women to chronic pelvic pain: systematic review
Latthe, P. M., Mignini, L. E., Gray, R. G., Hills, R. K., & Khan, K. S. (2006) · BMJ · doi:10.1136/bmj.38748.697465.55 · Cited by 582 · see citing works
How to read a paper: Papers that summarise other papers (systematic reviews and meta-analyses)
Greenhalgh, T. (1997) · BMJ · doi:10.1136/bmj.315.7109.672 · Cited by 574 · see citing works
Bronchodilators for bronchiolitis
Gadomski, A., & Scribani, M. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001266.pub4 · Cited by 566 · see citing works
Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children
Goldenberg, J. Z., Yap, C., Lytvyn, L., Lo, C. K.-F., Beardsley, J., Mertz, D., & Johnston, B. C. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006095.pub4 · Cited by 550 · see citing works
Bowden, J., Tierney, J. F., Copas, A. J., & Burdett, S. (2011) · BMC Medical Research Methodology · doi:10.1186/1471-2288-11-41 · Cited by 551 · see citing works
Hodges, L. J., Humphris, G. M., & Macfarlane, G. (2005) · Social Science & Medicine · doi:10.1016/j.socscimed.2004.04.018 · Cited by 533 · see citing works
Comprehensive literature review and statistical considerations for microarray meta-analysis
Tseng, G. C., Ghosh, D., & Feingold, E. (2012) · Nucleic Acids Research · doi:10.1093/nar/gkr1265 · Cited by 527 · see citing works
Freeman, M. C., Stocks, M. E., Cumming, O., Jeandron, A., Higgins, J. P. T., Wolf, J., Prüss‐Ustün, A., Bonjour, S., Hunter, P. R., Fewtrell, L., et al. (2014) · Tropical Medicine & International Health · doi:10.1111/tmi.12339 · Cited by 524 · see citing works
Hormone Replacement Therapy and Prevention of Nonvertebral Fractures
Torgerson, D. J., & Bell-Syer, S. E. (2001) · JAMA · doi:10.1001/jama.285.22.2891 · Cited by 521 · see citing works
Pharmacotherapy for post traumatic stress disorder (PTSD)
Stein, D. J., Ipser, J. C., Seedat, S., Sager, C., & Amos, T. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002795.pub2 · Cited by 519 · see citing works
Eikelboom, J. W., Quinlan, D. J., & Douketis, J. D. (2001) · The Lancet · doi:10.1016/s0140-6736(00)05249-1 · Cited by 512 · see citing works
Taylor, B., Irving, H. M., Kanteres, F., Room, R., Borges, G., Cherpitel, C., Greenfield, T., & Rehm, J. (2010) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2010.02.011 · Cited by 509 · see citing works
Higginson, I. J., Finlay, I. G., Goodwin, D. M., Hood, K., Edwards, A., Cook, A., Douglas, H.-R., & Normand, C. E. M. (2003) · Journal of Pain and Symptom Management · doi:10.1016/s0885-3924(02)00599-7 · Cited by 504 · see citing works
Asplund, K., Berman, P. H., Blomstrand, C., Dennis, M. S., Douglas, J. A., Erilä, T., Garraway, M. O., Hamrin, E., Hankey, G. J., Ilmavirta, M., et al. (1997) · Cited by 499 · see citing works
Lee, S. W. H., Ng, K. Y., & Chin, W. K. (2017) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2016.02.001 · Cited by 470 · see citing works
Wolf, J., Prüss‐Ustün, A., Cumming, O., Bartram, J., Bonjour, S., Cairncross, S., Clasen, T., Colford, J. M., Curtis, V., De France, J., et al. (2014) · Tropical Medicine & International Health · doi:10.1111/tmi.12331 · Cited by 461 · see citing works
A graphical tool for locating inconsistency in network meta-analyses
Krahn, U., Binder, H., & König, J. (2013) · BMC Medical Research Methodology · doi:10.1186/1471-2288-13-35 · Cited by 458 · see citing works
Approaches to heterogeneity in meta‐analysis
Petitti, D. B. (2001) · Statistics in Medicine · doi:10.1002/sim.1091 · Cited by 469 · see citing works
Evidence Synthesis for Decision Making 3
Dias, S., Sutton, A. J., Welton, N. J., & Ades, A. E. (2013) · Medical Decision Making · doi:10.1177/0272989x13485157 · Cited by 468 · see citing works
Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation
Arrich, J., Holzer, M. S., Havel, C., Müllner, M., & Herkner, H. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004128.pub4 · Cited by 454 · see citing works
Exploring sources of heterogeneity in systematic reviews of diagnostic tests
Lijmer, J. G., Bossuyt, P. M., & Heisterkamp, S. H. (2002) · Statistics in Medicine · doi:10.1002/sim.1185 · Cited by 446 · see citing works
A systematic overview of the incidence of posterior capsule opacification
Schaumberg, D. A., Dana, M. R., Christen, W. G., & Glynn, R. J. (1998) · Ophthalmology · doi:10.1016/s0161-6420(98)97023-3 · Cited by 443 · see citing works
Vanhoenacker, P. K., Heijenbrok‐Kal, M. H., Heste, R. V., Decramer, I., Hoe, L. R. V., Wijns, W. C., & Hunink, M. G. M. (2007) · Radiology · doi:10.1148/radiol.2442061218 · Cited by 442 · see citing works
Understanding heterogeneity in meta-analysis: the role of meta-regression
Baker, W. L., Michael White, C., Cappelleri, J. C., Kluger, J., Coleman, C. I., & From the Health Outcomes, P. (2009) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2009.02168.x · Cited by 492 · see citing works
Gillen, B. M., Looney, S. W., Gu, L.-S., Loushine, B. A., Weller, R. N., Loushine, R. J., Pashley, D. H., & Tay, F. R. (2011) · Journal of Endodontics · doi:10.1016/j.joen.2011.04.002 · Cited by 429 · see citing works
QUOROM Group, Moher, D., Cook, D. J., Eastwood, S., Olkin, I., Rennie, D., & Stroup, D. F. (2000) · British journal of surgery · doi:10.1046/j.1365-2168.2000.01610.x · Cited by 418 · see citing works
Confidence intervals for the amount of heterogeneity in meta‐analysis
Viechtbauer, W. (2006) · Statistics in Medicine · doi:10.1002/sim.2514 · Cited by 399 · see citing works
Lambert, P. C., Sutton, A. J., Abrams, K. R., & Jones, D. R. (2002) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(01)00414-0 · Cited by 396 · see citing works
Portal hypertension and variceal bleeding: An AASLD single topic symposium†
Grace, N. D., Groszmann, R. J., García–Tsao, G., Burroughs, A. K., Pagliaro, L., Makuch, R., Bosch, J., Stiegmann, G. V., Henderson, M. J., de Franchis, R., et al. (1998) · Hepatology · doi:10.1002/hep.510280339 · Cited by 389 · see citing works
A guide to interpreting discordant systematic reviews.
Jadad, A., Cook, D. J., & Browman, G. P. (1997) · Europe PMC (PubMed Central) · Cited by 393 · see citing works
Meta-Analytic Review of the Risk Factors for Acute Otitis Media
Uhari, M., Mantysaari, K., & Niemelä, M. (1996) · Clinical Infectious Diseases · doi:10.1093/clinids/22.6.1079 · Cited by 388 · see citing works
Quinlan, D. J., McQuillan, A., & Eikelboom, J. W. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-140-3-200402030-00008 · Cited by 384 · see citing works
Zintzaras, E., & Lau, J. (2008) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2007.12.011 · Cited by 360 · see citing works
Barker, F. G., & Ogilvy, C. S. (1996) · Journal of neurosurgery · doi:10.3171/jns.1996.84.3.0405 · Cited by 357 · see citing works
Thakkinstian, A., McEvoy, M., Minelli, C., Gibson, P. G., Hancox, B., Duffy, D. L., Thompson, J. R., Hall, I. P., Kaufman, J. D., Leung, T. F., et al. (2005) · American Journal of Epidemiology · doi:10.1093/aje/kwi184 · Cited by 356 · see citing works
Taylor, B., Irving, H. M., Baliunas, D., Roerecke, M., Patra, J., Mohapatra, S., & Rehm, J. (2009) · Addiction · doi:10.1111/j.1360-0443.2009.02694.x · Cited by 346 · see citing works
Magnesium Intake and Risk of Type 2 Diabetes
Dong, J.-Y., Xun, P., He, K., & Qin, L. (2011) · Diabetes Care · doi:10.2337/dc11-0518 · Cited by 375 · see citing works
Kong, D. F., Califf, R. M., Miller, D. P., Moliterno, D. J., White, H. D., Harrington, R. A., Tcheng, J. E., Lincoff, A. M., Hasselblad, V., & Topol, E. J. (1998) · Circulation · doi:10.1161/01.cir.98.25.2829 · Cited by 346 · see citing works
Soomro, G. M., Altman, D. G., Rajagopal, S., & Oakley Browne, M. (2008) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001765.pub3 · Cited by 342 · see citing works
Reliable assessment of the effects of treatment on mortality and major morbidity, I: clinical trials
Collins, R., & MacMahon, S. W. (2001) · The Lancet · doi:10.1016/s0140-6736(00)03651-5 · Cited by 337 · see citing works
Saint, S. K., Elmore, J. G., Sullivan, S. D., Emerson, S. S., & Koepsell, T. D. (1998) · The American Journal of Medicine · doi:10.1016/s0002-9343(98)00240-x · Cited by 329 · see citing works
Raghunath, A. S., Hungin, A. P. S., Wooff, D., & Childs, S. (2003) · BMJ · doi:10.1136/bmj.326.7392.737 · Cited by 327 · see citing works
Bivariate Random Effects Meta-Analysis of ROC Curves
Arends, L. R., Hamza, T. H., van Houwelingen, H. C., Heijenbrok‐Kal, M. H., Hunink, M. G. M., & Stijnen, T. (2008) · Medical Decision Making · doi:10.1177/0272989x08319957 · Cited by 325 · see citing works
Stettler, C., Allemann, S., Wandel, S., Kastrati, A., Morice, M. C., Schomig, A., Pfisterer, M. E., Stone, G. W., Leon, M. B., Lezo, J. S. D., et al. (2008) · BMJ · doi:10.1136/bmj.a1331 · Cited by 320 · see citing works
Prognosis for the co‐twin following single‐twin death: a systematic review
Ong, S., Zamora, J., Khan, K. S., & Kilby, M. D. (2006) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2006.01027.x · Cited by 317 · see citing works
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Reichenbach, S., Sterchi, R., Scherer, M., Trelle, S., Bürgi, E., Bürgi, U., Dieppe, P. A., & Jüni, P. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-8-200704170-00009 · Cited by 316 · see citing works
Neurofeedback with fMRI: A critical systematic review
Thibault, R. T., MacPherson, A., Lifshitz, M., Roth, R. R., & Raz, A. (2017) · NeuroImage · doi:10.1016/j.neuroimage.2017.12.071 · Cited by 300 · see citing works
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Attia, J. (2003) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(03)00011-8 · Cited by 311 · see citing works
Emami, E., Heydecke, G., Rompre, P. H., de Grandmont, P., & Feine, J. S. (2009) · Clinical Oral Implants Research · doi:10.1111/j.1600-0501.2008.01693.x · Cited by 299 · see citing works
Impact of Pharmacist Care in the Management of Cardiovascular Disease Risk Factors
Santschi, V. (2011) · Archives of Internal Medicine · doi:10.1001/archinternmed.2011.399 · Cited by 298 · see citing works
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Ades, A. E., Lu, G., & Claxton, K. (2004) · Medical Decision Making · doi:10.1177/0272989x04263162 · Cited by 364 · see citing works
Eccleston, C., Morley, S., Williams, A. C. D. C., Yorke, L., & Mastroyannopoulou, K. (2002) · Pain · doi:10.1016/s0304-3959(02)00072-6 · Cited by 295 · see citing works
Patel, A., Laffan, M., Waheed, U., & Brett, S. J. (2014) · BMJ · doi:10.1136/bmj.g4561 · Cited by 289 · see citing works
Systematic reviews of the effectiveness of quality improvement strategies and programmes
Grimshaw, J. (2003) · BMJ Quality & Safety · doi:10.1136/qhc.12.4.298 · Cited by 290 · see citing works
Meta-analysis of Cohen’s kappa
Sun, S. (2011) · Health Services and Outcomes Research Methodology · doi:10.1007/s10742-011-0077-3 · Cited by 282 · see citing works
Multivariate Random-effects Meta-analysis
White, I. R. (2009) · The Stata Journal Promoting communications on statistics and Stata · doi:10.1177/1536867x0900900103 · Cited by 289 · see citing works
Evaluation of various estimators for standardized mean difference in meta‐analysis
Lin, L., & Aloe, A. M. (2021) · Statistics in Medicine · doi:10.1002/sim.8781 · Cited by 297 · see citing works
A systematic review of school-based smoking prevention trials with long-term follow-up
Wiehe, S. E., Garrison, M. M., Christakis, D. A., Ebel, B. E., & Rivara, F. P. (2005) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2004.12.003 · Cited by 286 · see citing works
Meta‐analysis of continuous outcomes combining individual patient data and aggregate data
Riley, R. D., Lambert, P. C., Staessen, J. A., Wang, J., Gueyffier, F., Thijs, L., & Boutitie, F. (2007) · Statistics in Medicine · doi:10.1002/sim.3165 · Cited by 280 · see citing works
Warn, D. E., Thompson, S. G., & Spiegelhalter, D. J. (2002) · Statistics in Medicine · doi:10.1002/sim.1189 · Cited by 277 · see citing works
Self-citationMicroalbuminuria, blood pressure and diabetic renal disease: origin and development of ideas
Mogensen, C. E. (1999) · Diabetologia · doi:10.1007/s001250051151 · Cited by 274 · see citing works
Tang, J., Armitage, J., Lancaster, T., Silagy, C. A., Fowler, G. H., Neil, H. A. W., Smith, G. D., & Ebrahim, S. B. J. (1998) · BMJ · doi:10.1136/bmj.316.7139.1213 · Cited by 276 · see citing works
- Authors
- Thompson, S. G.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Corresponding author
- Thompson, S G
- ORCID
- Thompson, S G
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1994-11-19
- Volume
- 309
- Issue
- 6965
- Pages
- 1351-1355
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC2541868
- OpenAlex
- W1511524925
- Cited by
- 1,017
- References
- 32
- Citations by year
- 2026: 23 · 2025: 35 · 2024: 38 · 2023: 29 · 2022: 30 · 2021: 47 · 2020: 38 · 2019: 32 · 2018: 36 · 2017: 26 · 2016: 24 · 2015: 24 · 2014: 31 · 2013: 48 · 2012: 51
- FWCI
- 3.70
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- 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
- meta-analysis heterogeneity, clinical heterogeneity, statistical heterogeneity, serum cholesterol, cholesterol lowering, meta-analysis methodology, overfitting
- MeSH terms
- Adult, Aged, Aging, Cholesterol, Clinical Trials as Topic, Humans, Middle Aged, Neoplasms, Research Design, Meta-Analysis as Topic, Randomized Controlled Trials as Topic, Risk Assessment
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