Meta-analysis

Young Ho Lee

doi:10.4078/jrd.2015.22.1.4

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Lee: Meta-analysis

Review Article

J Rheum Dis 2015;22(1):4-9.

Published online: 31 October 2015

DOI: https://doi.org/10.4078/jrd.2015.22.1.4

Meta-analysis

Young Ho Lee

Division of Rheumatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea

Corresponding to: Young Ho Lee, Division of Rheumatology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 136-705, Korea. E-mail: lyhcgh@korea.ac.kr

Received 3 December 2014 Accepted 18 December 2014

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Meta-analysis is a statistical tool for combining the results of different studies on the same topic, providing a precise estimate of the effect size and increasing statistical strength, which is particularly important when the strength of the primary study is limited because of a small sample size. Properly conducted meta-analysis provides an invaluable link between past and future studies by quantitatively synthesizing evidence while minimizing bias. Recently, because studies on meta-analysis have been published increasingly, there is a need for rheumatologists to understand meta-analysis. In order to help rheumatologists in use of a meta-analysis, the author describes the basic steps in statistical analysis of a meta-analysis: 1) search for presence of between-study heterogeneity, 2) performing statistical analysis of meta-analysis, 3) checking publication bias, 4) search for causes of heterogeneity, and 5) interpreting and presenting meta-analysis results.

Keywords: Meta-analysis, Statistical analysis

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Figure 1.

Forrest plot of odds ratios (ORs) and 95% confidence interval (CIs) of individual studies and pooled data for the association between the C allele of the Fc receptor-like 3-169 C/T polymorphism and rheumatoid arthritis (RA) in each ethnic group. NAN: North American Native.

Figure 2.

Funnel plot of studies regarding the association between the Fc receptor-like 3-169 C allele and rheumatoid arthritis showed no evidence of asymmetry and Egger's regression test showed no significant p-value (Egger's regression test p-value=0.863), indicating no evidence of publication bias in the meta-analysis.

Table 1.

Process of statistical analysis of meta-analysis

1. Search for presence of between-study heterogeneity: Cochran Q test, I²

2. Performing meta-analysis: fixed or random effect model, forrest plot

3. Checking publication bias: funnel plot, Egger's regression test

4. Search for causes of heterogeneity: subgroup analysis, sensitivity analysis, meta-regression

5. Interpreting and presenting meta-analysis result

Table 2.

Meta-analysis of the associations between the FCRL3-169 C/T polymorphism and rheumatoid arthritis

Polymorphism	Population	No. of studies	Test of association			Test of heterogeneity
Polymorphism	Population	No. of studies	OR	95% CI	p-value	Model	p-value	I²
FCRL3	Overall	17	1.046	0.997∼1.098	0.068	R	0.084	34.1
C vs. T	European	9	1.012	0.962∼1.065	0.643	F	0.128	36.2
	Asian	7	1.101	1.035∼1.171	0.002	F	0.314	15.1
	Japanese	3	1.124	1.029∼1.227	0.009	F	0.266	24.5
	Non-Japanese	4	1.080	0.990∼1.177	0.082	F	0.260	25.2
CC vs. CT+TT (recessive)	Overall	17	1.069	0.977∼1.170	0.146	R	0.052	38.8
CC vs. CT+TT (recessive)	European	9	1.004	0.883∼1.141	0.955	R	0.040	50.5
	Asian	7	1.138	1.014∼1.277	0.028	F	0.418	0.75
	Japanese	3	1.216	1.027∼1.438	0.023	F	0.469	0
	Non-Japanese	4	1.074	0.917∼1.258	0.375	F	0.330	12.4
CC+CT vs. TT (dominant)	Overall	17	1.056	0.996∼1.119	0.066	F	0.328	10.7
	European	9	1.019	0.941∼1.102	0.647	F	0.641	0
	Asian	7	1.134	1.037∼1.241	0.006	F	0.449	0
	Japanese	3	1.144	1.006∼1.300	0.040	F	0.264	24.8
	Non-Japanese	4	1.125	0.992∼1.276	0.067	F	0.379	2.68
CC vs. TT	Overall	17	1.100	1.017∼1.190	0.018	F	0.105	31.4
	European	9	1.032	0.931∼1.144	0.549	F	0.129	36.1
	Asian	7	1.208	1.063∼1.373	0.004	F	0.300	16.9
	Japanese	3	1.282	1.064∼1.544	0.009	F	0.274	22.7
	Non-Japanese	4	1.146	0.961∼1.366	0.129	F	0.272	23.1
CC vs. CT	Overall	17	1.052	0.960∼1.154	0.275	R	0.084	34.0
	European	9	1.008	0.918∼1.106	0.872	R	0.064	45.7
	Asian	7	1.092	0.967∼1.234	0.157	F	0.575	0
	Japanese	3	1.174	0.983∼1.401	0.077	F	0.666	0
	Non-Japanese	4	1.024	0.865∼1.211	0.785	F	0.472	0

CI: confidence interval, F: fixed effect model, FCRL3: Fc receptor-like 3, OR: odds ratio, R: random effect model.

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