Cited by 1,017Meta-analysis and systematic reviewsStatistical Methods in EpidemiologyDelphi Technique in Research

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Systematic Review: Why sources of heterogeneity in meta-analysis should be investigated

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Thompson, S G·1994·BMJ

DOI 10.1136/bmj.309.6965.1351PMC PMC2541868

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Abstract

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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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
DOI: 10.1136/bmj.309.6965.1351
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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Systematic Review: Why sources of heterogeneity in meta-analysis should be investigated

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