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Evidence · Meta-analyses · continued

Random versus fixed effects: choosing rather than defaulting — a second dataset posts 31–60

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

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OkaforTL3Regular31 Jan 2025#31

Coming back to post #29, because the follow-up matters more than the original answer.

Why forest plots are more informative than pooled numbers: they show the variation across studies, which tells you whether the effect is consistent or heterogeneous. A narrow confidence interval around a meaningless centre is less useful than a wider interval that shows real differences.

0 likes 18mo
IO
i.oseiTL2 Moderator31 Jan 2025#32

Picking up post #29: that is the part I would want checked first.

Funnel plots: a plot of study effect size versus sample size that helps detect publication bias. If small studies are missing on the negative side, the funnel is asymmetrical.

32 likes 18mo
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OTeixeiraTL3Regular31 Jan 2025#33
i.grimaldi, post #13: Coming back to post #11, because the follow-up matters more than the original answer. Subgroup analysis: sometimes a meta-analysis reports separate pooled estimates for different subgroups (e.g., by baseline body mass index or by trial duration). Be cautious — many subgroup analyses are exploratory and less reliable than the main… Go to post

Study quality and weighting: some meta-analyses weight all studies equally; others weight by study size or study quality. The choice affects the result and should be stated and justified.

16 likes in reply to #13 18mo
SO
s.oyelaranTL2 Moderator1 Feb 2025#34
HHidalgo, post #6: Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own records is not any individual result; it is that they are dated and consecutive. Go to post

Fixed-effects versus random-effects models: fixed-effects assumes all studies are estimating the same thing and variation is sampling error. Random-effects assumes studies are estimating effects from different distributions and allows between-study variance. Choice matters if heterogeneity is high.

6 likes in reply to #6 18mo
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MJayawardenaTL3Regular1 Feb 2025#35

I read post #33 twice before replying, because I had assumed the opposite.

Inclusion and exclusion criteria: a meta-analysis is only as good as its inclusion criteria. If the criteria are too broad, apples and oranges get pooled. If they are too narrow, the meta-analysis answers a overly specific question.

0 likes 18mo
NZ
n.zielinskiTL2 Moderator1 Feb 2025#36

Subgroup analysis: sometimes a meta-analysis reports separate pooled estimates for different subgroups (e.g., by baseline body mass index or by trial duration). Be cautious — many subgroup analyses are exploratory and less reliable than the main analysis.

24 likes 18mo
EM
endpoint_marginTL2Member1 Feb 2025#37
d.bramley, post #18: This follows post #15 rather than contradicting it. Study quality and weighting: some meta-analyses weight all studies equally; others weight by study size or study quality. The choice affects the result and should be stated and justified. Go to post

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

11 likes in reply to #18 18mo
BT
b.teixeiraTL2 Moderator1 Feb 2025#38

post #37 is right about the mechanism and I think understates the practical bit.

When a meta-analysis is unhelpful: if the included studies are heterogeneous in population, intervention, or outcome, pooling them produces a number that represents nothing in particular. Reading the individual studies is more useful than reading the pooled estimate.

3 likes 18mo
ED
e.dalgleishTL3Regular2 Feb 2025 · edited#39

Pooled estimates and heterogeneity: when trials differ in population, duration, or comparator, a pooled estimate answers a question that no individual trial asked. High heterogeneity means effects genuinely differ across studies. The pooled number is an average of things that should not have been averaged.

3 likes 18mo
AK
ar.kravchenkoTL2 Moderator2 Feb 2025#40

Pooled estimates and heterogeneity: when trials differ in population, duration, or comparator, a pooled estimate answers a question that no individual trial asked. High heterogeneity means effects genuinely differ across studies. The pooled number is an average of things that should not have been averaged.

0 likes 18mo
SV
s.vanheckeTL2 Moderator2 Feb 2025 · edited#41
endpoint_margin, post #37: Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing. The correction was fair and I had been repeating something I had not checked carefully enough. Go to post

When a meta-analysis is unhelpful: if the included studies are heterogeneous in population, intervention, or outcome, pooling them produces a number that represents nothing in particular. Reading the individual studies is more useful than reading the pooled estimate.

0 likes in reply to #37 18mo
EC
excursion_checkTL3Regular2 Feb 2025#42

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

1 like 18mo
TV
t.verhoevenTL2 Moderator2 Feb 2025#43

Publication bias: what did not get published? Small studies with negative results are less likely to be published than large studies with positive results. A forest plot with only large studies on the positive end is a red flag for unpublished small negative studies.

10 likes 18mo
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taper_tableTL3Regular2 Feb 2025#44

Worth separating two things that post #40 runs together.

Why forest plots are more informative than pooled numbers: they show the variation across studies, which tells you whether the effect is consistent or heterogeneous. A narrow confidence interval around a meaningless centre is less useful than a wider interval that shows real differences.

22 likes 18mo
MA
m.adebayoTL2 Moderator3 Feb 2025#45

Picking up post #42: that is the part I would want checked first.

Thank you for the correction. I have edited my earlier post with a note rather than silently, so the thread still makes sense to read. The error was mine and it was the kind that comes from remembering a figure instead of looking it up.

0 likes 18mo
LC
l.chevalierTL3Regular3 Feb 2025#46

Fixed-effects versus random-effects models: fixed-effects assumes all studies are estimating the same thing and variation is sampling error. Random-effects assumes studies are estimating effects from different distributions and allows between-study variance. Choice matters if heterogeneity is high.

3 likes 18mo
AE
a.eriksenTL2 Moderator3 Feb 2025#47

Number needed to treat from a meta-analysis: can be computed from the pooled estimate if the baseline risk is specified. More interpretable than pooled relative effects.

15 likes 18mo
VD
vial_deskTL3Regular3 Feb 2025#48
z.szabo, post #28: Publication bias: what did not get published? Small studies with negative results are less likely to be published than large studies with positive results. A forest plot with only large studies on the positive end is a red flag for unpublished small negative studies. Go to post

Sensitivity analysis: the authors re-run the meta-analysis excluding studies one at a time, or by quality, to see whether the pooled estimate changes. Robust results stay similar even when individual studies are excluded.

30 likes in reply to #28 18mo
DB
d.barrosTL2 Moderator3 Feb 2025#49
e.ndiaye, post #7: Number needed to treat from a meta-analysis: can be computed from the pooled estimate if the baseline risk is specified. More interpretable than pooled relative effects. Go to post

Subgroup analysis: sometimes a meta-analysis reports separate pooled estimates for different subgroups (e.g., by baseline body mass index or by trial duration). Be cautious — many subgroup analyses are exploratory and less reliable than the main analysis.

1 like in reply to #7 18mo
NP
n.petrovTL2 Moderator4 Feb 2025 · edited#50
d.bramley, post #18: This follows post #15 rather than contradicting it. Study quality and weighting: some meta-analyses weight all studies equally; others weight by study size or study quality. The choice affects the result and should be stated and justified. Go to post

I read post #48 twice before replying, because I had assumed the opposite.

Inclusion and exclusion criteria: a meta-analysis is only as good as its inclusion criteria. If the criteria are too broad, apples and oranges get pooled. If they are too narrow, the meta-analysis answers a overly specific question.

6 likes in reply to #18 18mo
RA
r.aldana_pharmdTL4Pharmacist4 Feb 2025#51
ar.kravchenko, post #40: Pooled estimates and heterogeneity: when trials differ in population, duration, or comparator, a pooled estimate answers a question that no individual trial asked. High heterogeneity means effects genuinely differ across studies. The pooled number is an average of things that should not have been averaged. Go to post

Funnel plots: a plot of study effect size versus sample size that helps detect publication bias. If small studies are missing on the negative side, the funnel is asymmetrical.

18 likes in reply to #40 18mo
EV
e.vargaTL2 Moderator4 Feb 2025#52

Study quality and weighting: some meta-analyses weight all studies equally; others weight by study size or study quality. The choice affects the result and should be stated and justified.

25 likes 18mo
LG
lc_gradientTL3Analytical chemist4 Feb 2025#53

I read post #51 twice before replying, because I had assumed the opposite.

When a meta-analysis is unhelpful: if the included studies are heterogeneous in population, intervention, or outcome, pooling them produces a number that represents nothing in particular. Reading the individual studies is more useful than reading the pooled estimate.

0 likes 18mo
RZ
r.zielinskiTL2 Moderator4 Feb 2025#54

This follows post #51 rather than contradicting it.

For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.

0 likes 18mo
DB
dr_bhattacharyaTL3Physician5 Feb 2025#55
d.barros, post #49: Subgroup analysis: sometimes a meta-analysis reports separate pooled estimates for different subgroups (e.g., by baseline body mass index or by trial duration). Be cautious — many subgroup analyses are exploratory and less reliable than the main analysis. Go to post

Fixed-effects versus random-effects models: fixed-effects assumes all studies are estimating the same thing and variation is sampling error. Random-effects assumes studies are estimating effects from different distributions and allows between-study variance. Choice matters if heterogeneity is high.

12 likes in reply to #49 18mo
DV
d.vukovicTL2 Moderator5 Feb 2025#56
endpoint_margin, post #37: Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing. The correction was fair and I had been repeating something I had not checked carefully enough. Go to post

post #55 answers the question as asked. The question underneath it is different.

Inclusion and exclusion criteria: a meta-analysis is only as good as its inclusion criteria. If the criteria are too broad, apples and oranges get pooled. If they are too narrow, the meta-analysis answers a overly specific question.

4 likes in reply to #37 18mo
EF
e.ferreiraTL3Regular5 Feb 2025#57

Coming back to post #55, because the follow-up matters more than the original answer.

Funnel plots: a plot of study effect size versus sample size that helps detect publication bias. If small studies are missing on the negative side, the funnel is asymmetrical.

0 likes 18mo
TD
t.duarteTL2 Moderator5 Feb 2025 · edited#58

Study quality and weighting: some meta-analyses weight all studies equally; others weight by study size or study quality. The choice affects the result and should be stated and justified.

26 likes 18mo
CS
c.silvaTL2 Moderator5 Feb 2025#59

Worth separating two things that post #55 runs together.

Two things before anyone answers the substance.

First, the context in the first post is clear and specific. Second, the question is framed so that an answer can actually address it. Both are the norm here and both matter more than they sound.

8 likes 18mo
RG
r.girardTL2 Moderator5 Feb 2025#60

Pooled estimates and heterogeneity: when trials differ in population, duration, or comparator, a pooled estimate answers a question that no individual trial asked. High heterogeneity means effects genuinely differ across studies. The pooled number is an average of things that should not have been averaged.

2 likes 18mo