Interpretation of tests of heterogeneity and bias in meta-analysis

dc.contributor.authorIoannidis, J. P.en
dc.date.accessioned2015-11-24T19:09:20Z
dc.date.available2015-11-24T19:09:20Z
dc.identifier.issn1365-2753-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/20691
dc.rightsDefault Licence-
dc.subject*Bias (Epidemiology)en
dc.subjectConfidence Intervalsen
dc.subject*Data Interpretation, Statisticalen
dc.subjectEvidence-Based Medicineen
dc.subjectHumansen
dc.subject*Meta-Analysis as Topicen
dc.subjectPublication Biasen
dc.subjectRegression Analysisen
dc.subjectReproducibility of Resultsen
dc.subjectResearch Design/*standardsen
dc.subjectRisken
dc.subjectSensitivity and Specificityen
dc.titleInterpretation of tests of heterogeneity and bias in meta-analysisen
heal.abstractStatistical tests of heterogeneity and bias, in particular publication bias, are very popular in meta-analyses. These tests use statistical approaches whose limitations are often not recognized. Moreover, it is often implied with inappropriate confidence that these tests can provide reliable answers to questions that in essence are not of statistical nature. Statistical heterogeneity is only a correlate of clinical and pragmatic heterogeneity and the correlation may sometimes be weak. Similarly, statistical signals may hint to bias, but seen in isolation they cannot fully prove or disprove bias in general, let alone specific causes of bias, such as publication bias in particular. Both false-positive and false-negative signals of heterogeneity and bias can be common and their prevalence may be anticipated based on some rational considerations. Here I discuss the major common challenges and flaws that emerge in using and interpreting statistical tests of heterogeneity and bias in meta-analyses. I discuss misinterpretations that can occur at the level of statistical inference, clinical/pragmatic inference and specific cause attribution. Suggestions are made on how to avoid these flaws, use these tests properly and learn from them.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.primary10.1111/j.1365-2753.2008.00986.x-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/19018930-
heal.identifier.secondaryhttp://onlinelibrary.wiley.com/store/10.1111/j.1365-2753.2008.00986.x/asset/j.1365-2753.2008.00986.x.pdf?v=1&t=h0je8aqh&s=6f2967bdbd3a5d944674e07c3a4e4305c5679290-
heal.journalNameJ Eval Clin Practen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2008-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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