Abstract

BackgroundEstimated effects vary across studies, partly because of random sampling error and partly because of heterogeneity. In meta-analysis, the fraction of variance that is due to heterogeneity is estimated by the statistic I2. We calculate the bias of I2, focusing on the situation where the number of studies in the meta-analysis is small. Small meta-analyses are common; in the Cochrane Library, the median number of studies per meta-analysis is 7 or fewer.MethodsWe use Mathematica software to calculate the expectation and bias of I2.ResultsI2 has a substantial bias when the number of studies is small. The bias is positive when the true fraction of heterogeneity is small, but the bias is typically negative when the true fraction of heterogeneity is large. For example, with 7 studies and no true heterogeneity, I2 will overestimate heterogeneity by an average of 12 percentage points, but with 7 studies and 80 percent true heterogeneity, I2 can underestimate heterogeneity by an average of 28 percentage points. Biases of 12–28 percentage points are not trivial when one considers that, in the Cochrane Library, the median I2 estimate is 21 percent.ConclusionsThe point estimate I2 should be interpreted cautiously when a meta-analysis has few studies. In small meta-analyses, confidence intervals should supplement or replace the biased point estimate I2.

Highlights

  • Estimated effects vary across studies, partly because of random sampling error and partly because of heterogeneity

  • When different studies estimate the effect of a treatment or exposure, the estimates will vary from one study to another. Some of this between-study variance comes from random sampling error, while some may come from heterogeneity

  • We show that I2 is not just imprecise; it is biased

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Summary

Introduction

Estimated effects vary across studies, partly because of random sampling error and partly because of heterogeneity. In meta-analysis, the fraction of variance that is due to heterogeneity is estimated by the statistic I2. When different studies estimate the effect of a treatment or exposure, the estimates will vary from one study to another. Some of this between-study variance comes from random sampling error, while some may come from heterogeneity. There are several sources of heterogeneity, including differences in the treatment, the treated population, the study design, or the data analysis method. When there is no heterogeneity, estimates are said to be homogeneous and differ only because of random sampling error. If the existing studies are very heterogeneous, unless the reasons for heterogeneity are well understood, the effect of the treatment on new subjects will be hard to predict [1]

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