Journal of Health and Medical Sciences
ISSN 2622-7258
Published: 22 December 2023
Evaluating Heterogeneity in Meta-Analyses: A Review
Rahman Hamze
Rafsanjan University of Medical Sciences
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10.31014/aior.1994.06.04.298
Pages: 253-263
Keywords: Meta-Analysis, Heterogeneity, Statistical Methods, Research Synthesis, Methodological Rigor
Abstract
Meta-analysis, as a fundamental aspect of evidence-based practice, synthesizes findings from multiple studies to draw comprehensive conclusions. A critical element of this synthesis is heterogeneity - the variability in outcomes, methodologies, and characteristics across studies. This review provides an in-depth exploration of heterogeneity in meta-analyses, highlighting its types, impact, and evolution over time. It emphasizes the significance of methodological rigor in detecting and managing heterogeneity, which is crucial for the credibility and utility of meta-analytic results. We delve into the methods for evaluating heterogeneity, including statistical tests like Cochran's Q test and the I² statistic, and visual methods such as forest plots and funnel plots. The paper also discusses strategies for managing identified heterogeneity, such as subgroup analysis, meta-regression, and sensitivity analysis, and the importance of choosing the appropriate statistical model. Advanced developments in heterogeneity evaluation, driven by statistical, technological, and methodological innovations, are also examined. This includes Bayesian approaches, individual participant data (IPD) meta-analysis, and automated tools for literature search and data extraction. The review includes case studies to demonstrate the application of these methods in various research contexts, underscoring the complexity and necessity of continuous advancements in handling heterogeneity. This paper serves as a comprehensive guide for researchers, contributing to the enhancement of meta-analytic practices and the quality of research findings across disciplines.
References
Alhasan, A. S., Daqqaq, T. S., Alhasan, M. S., Ghunaim, H. A., & Aboualkheir, M. (2023). Complication Rates and Risk of Recurrence After Percutaneous Radiofrequency Ablation and Microwave Ablation for the Treatment of Liver Tumors: a Meta-analysis. Acad Radiol. https://doi.org/10.1016/j.acra.2023.11.005
Bhattacharjee, P., & Khan, Z. (2023). Sacubitril/Valsartan in the Treatment of Heart Failure With Reduced Ejection Fraction Focusing on the Impact on the Quality of Life: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Cureus, 15(11), e48674. https://doi.org/10.7759/cureus.48674
Chen, S., Xu, X., Gong, H., Chen, R., Guan, L., Yan, X., Zhou, L., Yang, Y., Wang, J., Zhou, J., Zou, C., & Huang, P. (2023). Global epidemiological features and impact of osteosarcopenia: A comprehensive meta-analysis and systematic review. J Cachexia Sarcopenia Muscle. https://doi.org/10.1002/jcsm.13392
Cormier, P., Meylan, C., Agar-Newman, D., Geneau, D., Epp-Stobbe, A., Lenetsky, S., & Klimstra, M. (2023). A Systematic Review and Meta-Analysis of Wearable Satellite System Technology for Linear Sprint Profiling: Technological Innovations and Practical Applications. J Strength Cond Res. https://doi.org/10.1519/jsc.0000000000004689
Dong, Y., Shi, J., Wang, S., Liu, Y., Yu, S., & Zhao, L. (2023). The efficacy of immunosuppressive drugs induction therapy for lupus nephritis: a systematic review and network meta-analysis. Ren Fail, 45(2), 2290365. https://doi.org/10.1080/0886022x.2023.2290365
Ghasemirad, M., Ketabi, L., Fayyazishishavan, E., Hojati, A., Maleki, Z. H., Gerami, M. H., Moradzadeh, M., Fernandez, J. H. O., & Akhavan-Sigari, R. (2023). The association between screen use and central obesity among children and adolescents: a systematic review and meta-analysis. J Health Popul Nutr, 42(1), 51. https://doi.org/10.1186/s41043-023-00391-5
Huang, X., Dannya, E., Liu, X., Yu, Y., Tian, P., & Li, Z. (2023). Effect of sodium-glucose cotransporter-2 inhibitors on myocardial infarction incidence: A systematic review and meta-analysis of randomized controlled trials and cohort studies. Diabetes Obes Metab. https://doi.org/10.1111/dom.15405
Ji, H., Yang, Y., Lu, Y., Kong, X., Yang, G., Liu, J., Yang, Y., Wang, X., & Ma, X. (2023). Prevalence of dry eye during the COVID-19 pandemic: A systematic review and meta-analysis. PLoS One, 18(12), e0288523. https://doi.org/10.1371/journal.pone.0288523
Kazemi, S. M., Khorram, R., Fayyazishishavan, E., Amani-Beni, R., Haririan, Y., Hosseini Khameneh, S. M., Rahmani, E., Minaei Noshahr, R., Sarikhani, M., Rahimi, R., Saeidi, S., Saeidi, D., & Farrokhi, M. (2023). Diagnostic Accuracy of Ottawa Knee Rule for Diagnosis of Fracture in Patients with Knee Trauma; a Systematic Review and Meta-analysis. Arch Acad Emerg Med, 11(1), e30. https://doi.org/10.22037/aaem.v11i1.1934
Li, L., Zhong, H., Shao, Y., Hua, Y., Zhou, X., & Luo, D. (2023). Association between the homeostasis model assessment of insulin resistance and coronary artery calcification: a meta-analysis of observational studies. Front Endocrinol (Lausanne),14, 1271857. https://doi.org/10.3389/fendo.2023.1271857
Mokhtari-Ardekani, A., Fayyazishishavan, E., Akhavanfar, R. Abbasalizad-Farhangi, M. (2023). Circulating Advanced Oxidation Protein Products (AOPPs) increases the risk of metabolic syndrome among adults: A systematic review and meta-analysis. International Journal of Diabetes in Developing Countries. https://doi.org/https://doi.org/10.1007/s13410-023-01178-4
Mousavi, S. H., Khorramroo, F., Minoonejad, H., & Zwerver, J. (2023). Effects of biofeedback on biomechanical factors associated with chronic ankle instability: a systematic review with meta-analysis. BMC Sports Sci Med Rehabil, 15(1), 168. https://doi.org/10.1186/s13102-023-00780-7
Oliva Morgado Ferreira, R., Trevisan, T., Pasqualotto, E., Chavez, M. P., Marques, B. F., Lamounier, R. N., & van de Sande-Lee, S. (2023). Continuous glucose monitoring systems in non-insulin-treated people with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Diabetes Technol Ther. https://doi.org/10.1089/dia.2023.0390
Pereira, M., Castro, C. T., Magno, L., Oliveira, T. A., Gomes, F. S., Neves, F. M. F., Nascimento, P., & Dourado, I. (2023). Adverse effects of daily oral pre-exposure prophylaxis in men who have sex with men and transgender women: a systematic review and meta-analysis. Cad Saude Publica, 39Suppl 1(Suppl 1), e00089522. https://doi.org/10.1590/0102-311xen089522
Phoophiboon, V., Owattanapanich, N., Owattanapanich, W., & Schellenberg, M. (2023). Effects of prone positioning on ARDS outcomes of trauma and surgical patients: a systematic review and meta-analysis. BMC Pulm Med, 23(1), 504. https://doi.org/10.1186/s12890-023-02805-w
Rahmani, E., Amani-Beni, R., Hekmatnia, Y., Fakhre Yaseri, A., Ahadiat, S. A., Talebi Boroujeni, P., Kiani, M., Tavakoli, R., Shafagh, S. G., Shirazinia, M., Garousi, S., Mottahedi, M., Arzaghi, M., Pourbagher Benam, S., Rigi, A., Salmani, A., Abdollahi, Z., Karimzade Rokni, F., Nikbakht, T., . . . Farrokhi, M. (2023). Diagnostic Accuracy of Ultrasonography for Detection of Intussusception in Children; a Systematic Review and Meta-Analysis. Arch Acad Emerg Med, 11(1), e24. https://doi.org/10.22037/aaem.v11i1.1914
Rahmani, E., Fayyazishishavan, E., Afzalian, A., Varshochi, S., Amani-Beni, R., Ahadiat, S. A., Moshtaghi, Z., Shafagh, S. G., Khorram, R., Asadollahzade, E., Atbaei, R., Kahrizi, M. S., Rahbari, A., Baharlouie, N., Mostanbet, F., Amirabadiquchani, B., Kiani, M., Memarizadeh, M., Keshtkar Rajabi, S., . . . Farrokhi, M. (2023). Point-Of-Care Ultrasonography for Identification of Skin and Soft Tissue Abscess in Adult and Pediatric Patients; a Systematic Review and Meta-Analysis. Arch Acad Emerg Med, 11(1), e49. https://doi.org/10.22037/aaem.v11i1.2021
Rokhshad, R., Salehi, S. N., Yavari, A., Shobeiri, P., Esmaeili, M., Manila, N., Motamedian, S. R., & Mohammad-Rahimi, H. (2023). Deep learning for diagnosis of head and neck cancers through radiographic data: a systematic review and meta-analysis. Oral Radiol. https://doi.org/10.1007/s11282-023-00715-5
Salazar de Pablo, G., Aymerich, C., Guinart, D., Catalan, A., Alameda, L., Trotta, G., Armendariz, A., Martinez Baringo, E., Soler-Vidal, J., Rubio, J. M., Garrido-Torres, N., Gómez-Vallejo, S., Kane, J. M., Howes, O., Fusar-Poli, P., & Correll, C. U. (2023). What is the duration of untreated psychosis worldwide? - A meta-analysis of pooled mean and median time and regional trends and other correlates across 369 studies. Psychol Med, 1-11. https://doi.org/10.1017/s0033291723003458
Sharma, M., Papisetty, S., Dhawan, S., Ahluwalia, M. S., Venteicher, A. S., & Chen, C. C. (2023). Comparison of Stereotactic Radiosurgery (SRS) and Hypo-fractionated Radiosurgery (hSRS) for Vestibular Schwannomas: A Meta-Analysis of available literature. World Neurosurg. https://doi.org/10.1016/j.wneu.2023.12.029
Smela, B., Toumi, M., Swierk, K., Gawlik, K., Clay, E., & Boyer, L. (2023). Systematic literature reviews over the years. J Mark Access Health Policy, 11(1), 2244305. https://doi.org/10.1080/20016689.2023.2244305
Soleimani, E., Ardekani, A. M., Fayyazishishavan, E., & Farhangi, M. A. (2023). The interactive relationship of dietary choline and betaine with physical activity on circulating creatine kinase (CK), metabolic and glycemic markers, and anthropometric characteristics in physically active young individuals. BMC Endocr Disord, 23(1), 158. https://doi.org/10.1186/s12902-023-01413-3
Taghizadeh, S., Hashemi, M. G., Zarnag, R. K., Fayyazishishavan, E., Gholami, M., Farhangi, M. A., & Gojani, L. J. (2022). Barriers and facilitators of childhood obesity prevention policies: A systematic review and meta-synthesis. Front Pediatr, 10, 1054133. https://doi.org/10.3389/fped.2022.1054133
Taşçı, Ö., Özer, N., & Çoğaltay, N. (2023). The Effect of Virtual Reality Application on Pain During Wound Care Dressing Change: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Pain Manag Nurs. https://doi.org/10.1016/j.pmn.2023.11.008
Varhlunchungi, V., Kalaivani, M., Hemraj, C., Gupta, S., Malhotra, S., & Tandon, N. (2023). Metabolic Syndrome Among Adolescents Aged 10-19 Years in India: A Systematic Review and Meta-Analysis. Cureus,15(11), e48636. https://doi.org/10.7759/cureus.48636
Zhang, H., Li, X., Sun, W., Zhang, R., & Cai, W. (2023). Comparison of complications and indwelling time of midline catheter at different tip locations: A systematic review and meta-analysis. J Vasc Access, 11297298231199776. https://doi.org/10.1177/11297298231199776
Zhao, H., Wang, L., Fang, C., Li, C., & Zhang, L. (2023). Factors influencing the diagnostic and prognostic values of circulating tumor cells in breast cancer: a meta-analysis of 8,935 patients. Front Oncol, 13, 1272788. https://doi.org/10.3389/fonc.2023.1272788