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Evidence · Meta-analyses · continued

Pooling trials with different estimands — what changed since posts 31–60

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

RR
r.restrepoTL2 Moderator30 Sep 2025#31

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.

16 likes 10mo
CC
c.correiaTL2 Moderator3 Oct 2025#32

On post #28 — agreed on the reasoning, with one qualification.

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.

32 likes 10mo
ME
me.eriksenTL2 Moderator5 Oct 2025 · edited#33
s.lindqvist, post #9: I read post #7 twice before replying, because I had assumed the opposite. 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

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.

1 like in reply to #9 10mo
KS
k.salinasTL2 Moderator7 Oct 2025#34

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.

6 likes 10mo
SO
sa.okonkwoTL2 Moderator10 Oct 2025#35

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.

23 likes 10mo
AW
a.westergaardTL3Regular12 Oct 2025#36

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.

0 likes 10mo
MM
m.malinowskiTL2 Moderator14 Oct 2025#37
j.delacroix, post #7: On post #3 — agreed on the reasoning, with one qualification. 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

This follows post #34 rather than contradicting it.

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.

3 likes in reply to #7 9mo
ML
m.lindqvistTL2 Moderator17 Oct 2025#38
j.petrov, post #15: 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

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.

10 likes in reply to #15 9mo
BB
b.brandtTL2 Moderator19 Oct 2025#39

post #38 answers the question as asked. The question underneath it is different.

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.

7 likes 9mo
M
MSaarinenTL3Regular21 Oct 2025#40

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.

17 likes 9mo
DV
d.vestergaardTL2 Moderator24 Oct 2025#41

On post #37 — agreed on the reasoning, with one qualification.

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.

24 likes 9mo
VT
vial_tableTL2Member26 Oct 2025#42

post #41 answers the question as asked. The question underneath it is different.

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.

11 likes 9mo
CM
c.marchettiTL2 Moderator28 Oct 2025#43
f.kimani, post #17: I disagree with the reply above, and I think the disagreement is substantive rather than terminological. The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient. Go to post

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.

3 likes in reply to #17 9mo
D
DOdendaalTL3Regular30 Oct 2025#44

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 9mo
LC
l.cabreraTL2 Moderator1 Nov 2025#45

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.

18 likes 9mo
SF
sterile_fileTL3Regular4 Nov 2025#46

post #45 is right about the mechanism and I think understates the practical bit.

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.

7 likes 9mo
FP
f.petrovTL2 Moderator6 Nov 2025 · edited#47
c.dahlberg, post #13: post #12 is right about the mechanism and I think understates the practical bit. 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… Go to post

I read post #45 twice before replying, because I had assumed the opposite.

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.

1 like in reply to #13 9mo
AS
a.stephanopoulosTL3Regular8 Nov 2025#48

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.

0 likes 9mo
IW
i.wojcikTL2 Moderator10 Nov 2025#49

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.

12 likes 9mo
V
VPoulsenTL3Regular12 Nov 2025#50
endo_fellow_rk, post #25: Coming back to post #23, because the follow-up matters more than the original answer. 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

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.

4 likes in reply to #25 8mo
NV
n.vukovicTL2 Moderator14 Nov 2025#51

Picking up post #48: that is the part I would want checked first.

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 8mo
PN
plateau_notesTL2Regular17 Nov 2025#52

Coming back to post #50, 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 analysis.

0 likes 8mo
NC
n.cardosoTL2 Moderator19 Nov 2025#53
j.delacroix, post #7: On post #3 — agreed on the reasoning, with one qualification. 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

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.

4 likes in reply to #7 8mo
OL
o.lindgrenTL2Regular21 Nov 2025#54

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.

12 likes 8mo
RP
r.petrovTL2 Moderator23 Nov 2025#55

This follows post #52 rather than contradicting it.

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.

26 likes 8mo
P
preregisteredTL3Research methods25 Nov 2025#56

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 8mo
BV
b.vanheckeTL2 Moderator27 Nov 2025 · edited#57
j.baptista, post #14: Worth separating two things that post #10 runs together. 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

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.

2 likes in reply to #14 8mo
PE
ppm_errorTL3Analytical chemist29 Nov 2025#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.

8 likes 8mo
AK
a.krastevTL2 Moderator1 Dec 2025#59

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.

19 likes 8mo
G
GEldridgeTL3Regular3 Dec 2025#60

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.

0 likes 8mo