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Statistical Methods for Examining Heterogeneity and Combining Results from Several Studies in Meta‐Analysis
- Publisher
- SAGE
- Copyright
- © 2014 British Medical Acupuncutre Society
- ISSN
- 0964-5284
- eISSN
- 1759-9873
- DOI
- 10.1136/acupmed-2013-010364
- pmid
- 24140758
- Publisher site
- See Article on Publisher Site
Abstract
ObjectivesTo illustrate the pitfalls of using meta-analysis to combine estimates of effect in trials that are highly varied and have a high potential for bias.MethodsWe used a random-effects meta-analysis to pool the results of 51 sham-controlled acupuncture trials of chronic pain published in English before 2008 and explored the heterogeneity using meta-regression. We repeated the process on a subset of these trials that used a visually credible non-penetrating sham device as control (N = 12).ResultsIn both analyses there were high levels of heterogeneity and many studies were at risk from potential bias. The heterogeneity was not explained by meta-regression.ConclusionsTrials of interventions that have high potential for bias, such as many in the acupuncture literature, do not meet the assumptions of the statistical procedure that underlie random-effects meta-analysis. Even in the absence of bias, heterogeneity in meta-analyses is not accounted for by the CIs around the pooled estimate.
Journal
Acupuncture in Medicine – SAGE
Published: Feb 1, 2014