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Cited by 222Meta-analysis and systematic reviewsDelphi Technique in ResearchClinical practice guidelines implementation

The DOI matches its Crossref record; 127 of the 127 references it cites were found in a registry or an index.

Investigating clinical heterogeneity in systematic reviews: a methodologic review of guidance in the literature

Open access
Gagnier, Joel J, Moher, David, Boon, Heather, Beyene, Joseph, Bombardier, Claire·2012·BMC Medical Research Methodology
DOI 10.1186/1471-2288-12-111PMC PMC3564789
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Abstract

BACKGROUND: While there is some consensus on methods for investigating statistical and methodological heterogeneity, little attention has been paid to clinical aspects of heterogeneity. The objective of this study is to summarize and collate suggested methods for investigating clinical heterogeneity in systematic reviews. METHODS: We searched databases (Medline, EMBASE, CINAHL, Cochrane Library, and CONSORT, to December 2010) and reference lists and contacted experts to identify resources providing suggestions for investigating clinical heterogeneity between controlled clinical trials included in systematic reviews. We extracted recommendations, assessed resources for risk of bias, and collated the recommendations. RESULTS: One hundred and one resources were collected, including narrative reviews, methodological reviews, statistical methods papers, and textbooks. These resources generally had a low risk of bias, but there was minimal consensus among them. Resources suggested that planned investigations of clinical heterogeneity should be made explicit in the protocol of the review; clinical experts should be included on the review team; a set of clinical covariates should be chosen considering variables from the participant level, intervention level, outcome level, research setting, or others unique to the research question; covariates should have a clear scientific rationale; there should be a sufficient number of trials per covariate; and results of any such investigations should be interpreted with caution. CONCLUSIONS: Though the consensus was minimal, there were many recommendations in the literature for investigating clinical heterogeneity in systematic reviews. Formal recommendations for investigating clinical heterogeneity in systematic reviews of controlled trials are required.

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Research works printed but not linked: 2

  1. British Medical Journal. 2009, Available at: http://clinicalevidence.bmj.com/ceweb/about/index.jsp . Accessed February 16, 2009
  2. Glasziou P, Chalmers I, Altman DG, et al: Taking healthcare interventions from trial to practice. BMJ. 2010, 341: 384-387.

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Metadata

Authors
Gagnier, J. J., Moher, D., Boon, H., Beyene, J., & Bombardier, C.
Affiliations
  • University of Michigan (US)
  • University of Ottawa (CA)
  • University of Toronto (CA)
  • Hospital for Sick Children (CA)
Corresponding author
Gagnier, Joel J
ORCID
Venue
BMC Medical Research Methodology
Publisher
Springer Science and Business Media LLC
Published
2012-07-30
Volume
12
Issue
1
Pages
111-111
ISSN
1471-2288 (ISSN-L)
DOI
10.1186/1471-2288-12-111
PMC
PMC3564789
OpenAlex
W1990368073
Cited by
222
References
127
Citations by year
2026: 17 · 2025: 24 · 2024: 24 · 2023: 21 · 2022: 24 · 2021: 37 · 2020: 19 · 2019: 22 · 2018: 5 · 2017: 7 · 2016: 5 · 2015: 9 · 2014: 5 · 2013: 3
FWCI
1.50
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Medical Research Methodology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Deep Blue (University of Michigan) (submittedVersion)
  • TSpace (University of Toronto) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • uO Research (University of Ottawa) (submittedVersion, public-domain)
Topics
  • Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
  • Social Sciences › Sociology and Political Science › Delphi Technique in Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Keywords
clinical heterogeneity, covariate selection, risk of bias, methodological recommendations, subgroup analysis
MeSH terms
Systematic Reviews as Topic, Bayes Theorem, Clinical Trials as Topic, Data Interpretation, Statistical, Humans, Meta-Analysis as Topic, Epidemiologic Research Design, Bias, Databases, Bibliographic, Controlled Clinical Trials as Topic, Evidence-Based Medicine

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