Cited by 453Meta-analysis and systematic reviewsStatistical Methods in EpidemiologyDelphi Technique in Research

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Random-Effects Meta-analysis of Inconsistent Effects: A Time for Change

Cornell, John E., Mulrow, Cynthia D., Localio, Russell, Stack, Catharine B., Meibohm, Anne R., Guallar, Eliseo, Goodman, Steven N.·2014·Annals of Internal Medicine

DOI 10.7326/m13-2886

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Abstract

A primary goal of meta-analysis is to improve the estimation of treatment effects by pooling results of similar studies. This article explains how the most widely used method for pooling heterogeneous studies--the Der Simonian-Laird (DL) estimator--can produce biased estimates with falsely high precision. A classic example is presented to show that use of the DL estimator can lead to erroneous conclusions. Particular problems with the DL estimator are discussed, and several alternative methods for summarizing heterogeneous evidence are presented. The authors support replacing universal use of the DL estimator with analyses based on a critical synthesis that recognizes the uncertainty in the evidence,focuses on describing and explaining the probable sources of variation in the evidence, and uses random-effects estimates that provide more accurate confidence limits than the DL estimator.

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Authors: Cornell, J. E., Mulrow, C. D., Localio, R., Stack, C. B., Meibohm, A. R., Guallar, E., & Goodman, S. N.
Affiliations: Johns Hopkins University (US)
From University of Texas Health Science Center at San Antonio, San Antonio, Texas; University of Pennsylvania and American College of Physicians, Philadelphia, Pennsylvania; Johns Hopkins School of Public Health, Baltimore, Maryland; and Stanford University School of Medicine, Stanford, California.
ORCID: Cornell, John E.
Mulrow, Cynthia D.
Goodman, Steven N.
Venue: Annals of Internal Medicine
Publisher: American College of Physicians
Published: 2014-02-18
Volume: 160
Issue: 4
Pages: 267-270
ISSN: 0003-4819 (ISSN-L)
1539-3704
DOI: 10.7326/m13-2886
OpenAlex: W2129670822
Cited by: 453
References: 28
Citations by year: 2026: 17 · 2025: 34 · 2024: 30 · 2023: 17 · 2022: 26 · 2021: 54 · 2020: 34 · 2019: 58 · 2018: 42 · 2017: 41 · 2016: 51 · 2015: 28 · 2014: 20
FWCI: 12.77
Type: journal article
Language: en
Open access: closed
Licence: www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations: Annals of Internal Medicine (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: random-effects meta-analysis, heterogeneity, treatment effect estimation, confidence limits, critical synthesis
MeSH terms: Data Interpretation, Statistical, Software, Meta-Analysis as Topic, Confidence Intervals

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