Cited by 842Meta-analysis and systematic reviewsStatistical Methods in Clinical TrialsDelphi Technique in Research

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Mean Difference, Standardized Mean Difference (SMD), and Their Use in Meta-Analysis: As Simple as It Gets

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Andrade, Chittaranjan·2020·The Journal of Clinical Psychiatry

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Abstract

In randomized controlled trials (RCTs), endpoint scores, or change scores representing the difference between endpoint and baseline, are values of interest. These values are compared between experimental and control groups, yielding a mean difference between the experimental and control groups for each outcome that is compared. When the mean difference values for a specified outcome, obtained from different RCTs, are all in the same unit (such as when they were all obtained using the same rating instrument), they can be pooled in meta-analysis to yield a summary estimate that is also known as a mean difference (MD). Because pooling of the mean difference from individual RCTs is done after weighting the values for precision, this pooled MD is also known as the weighted mean difference (WMD). Sometimes, different studies use different rating instruments to measure the same outcome; that is, the units of measurement for the outcome of interest are different across studies. In such cases, the mean differences from the different RCTs cannot be pooled. However, these mean differences can be divided by their respective standard deviations (SDs) to yield a statistic known as the standardized mean difference (SMD). The SD that is used as the divisor is usually either the pooled SD or the SD of the control group; in the former instance, the SMD is known as Cohen's d, and in the latter instance, as Glass' delta. SMDs of 0.2, 0.5, and 0.8 are considered small, medium, and large, respectively. SMDs can be pooled in meta-analysis because the unit is uniform across studies. This article presents and explains the different terms and concepts with the help of simple examples.

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Additional file 40 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 18 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 16 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 2 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 46 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 20 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 7 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 28 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 41 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 13 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 44 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 6 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 15 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 10 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 32 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 19 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
Sobeeh, M. G., Hassan, K. A., da Silva, A. G., Youssef, E. F., Fayaz, N. A., & Mohammed, M. M. (2023) · Figshare · doi:10.6084/m9.figshare.22599370
Additional file 5 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
Sobeeh, M. G., Hassan, K. A., da Silva, A. G., Youssef, E. F., Fayaz, N. A., & Mohammed, M. M. (2023) · Figshare · doi:10.6084/m9.figshare.22599328
Additional file 11 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
Sobeeh, M. G., Hassan, K. A., da Silva, A. G., Youssef, E. F., Fayaz, N. A., & Mohammed, M. M. (2023) · Figshare · doi:10.6084/m9.figshare.22599346
Additional file 26 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
Sobeeh, M. G., Hassan, K. A., da Silva, A. G., Youssef, E. F., Fayaz, N. A., & Mohammed, M. M. (2023) · Figshare · doi:10.6084/m9.figshare.22599391
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Chan-Víquez, D., Fernández-Huertas, H., Montserrat-Gonzalez, C., Khan, A., Fehlings, D. L., Munce, S., Wright, F. V., & Biddiss, E. A. (2024) · Figshare · doi:10.6084/m9.figshare.26945937
Additional file 29 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
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Additional file 1 of Real-world clinical outcomes and treatment patterns in patients with MDD treated with vortioxetine: a retrospective study
McDaniel, B. T., Cornet, V. P., Carroll, J., Chrones, L., Chudzik, J., Cochran, J., Guha, S., Lawrence, D. F. E., McCue, M., Sarkey, S., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26653461
Additional file 25 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
Sobeeh, M. G., Hassan, K. A., da Silva, A. G., Youssef, E. F., Fayaz, N. A., & Mohammed, M. M. (2023) · Figshare · doi:10.6084/m9.figshare.22599388
Additional file 43 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
Sobeeh, M. G., Hassan, K. A., da Silva, A. G., Youssef, E. F., Fayaz, N. A., & Mohammed, M. M. (2023) · Figshare · doi:10.6084/m9.figshare.22599442
Additional file 45 of Pain mechanisms in complex regional pain syndrome: a systematic review and meta-analysis of quantitative sensory testing outcomes
Sobeeh, M. G., Hassan, K. A., da Silva, A. G., Youssef, E. F., Fayaz, N. A., & Mohammed, M. M. (2023) · Figshare · doi:10.6084/m9.figshare.22599448
Additional file 1 of Effect of zinc supplementation on glycemic biomarkers: an umbrella of interventional meta-analyses
Daneshvar, M., Ghaheri, M., Safarzadeh, D., Karimi, F., Adib-Hajbagheri, P., Ahmadzade, M., & Haedi, A. (2024) · Figshare · doi:10.6084/m9.figshare.26731264

Authors: Andrade, C.
Affiliations: National Institute of Mental Health and Neurosciences (IN)
Corresponding author: Andrade, Chittaranjan
ORCID: Andrade, Chittaranjan
Venue: The Journal of Clinical Psychiatry
Publisher: Physicians Postgraduate Press, Inc
Published: 2020-09-22
Volume: 81
Issue: 5
ISSN: 0160-6689 (ISSN-L)
1555-2101
DOI: 10.4088/jcp.20f13681
OpenAlex: W3089264828
Cited by: 841
References: 5
Citations by year: 2026: 158 · 2025: 221 · 2024: 199 · 2023: 161 · 2022: 77 · 2021: 25
FWCI: 40.09
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: The Journal of Clinical Psychiatry (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 Clinical Trials
Social Sciences › Sociology and Political Science › Delphi Technique in Research
Keywords: mean difference, standardized mean difference, Cohen's d, effect size, meta-analysis, change scores, rating instruments, effect size heterogeneity
MeSH terms: Data Interpretation, Statistical, Humans, Statistics as Topic, Meta-Analysis as Topic

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