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Evaluation & the Health Professions, Vol. 24, No. 2,
126-151 (2001)
DOI: 10.1177/016327870102400203
Methods for Exploring Heterogeneity in Meta-Analysis
Fujian Song
University of Birmingham, U.K.
Trevor A. Sheldon
University of York, U.K.
Alex J. Sutton
Keith R. Abrams
David R. Jones
University of Leicester, U.K.
In meta-analysis, when the difference in results between studies is greater than would be expected by chance, one needs to investigate whether the observed variation in results across studies is associated with clinical and/or methodological differences between studies. This article reviews methods used in meta-analysis for exploring heterogeneity, including statistical tests for homogeneity, methods for visually displaying results of primary studies, methods for reducing heterogeneity, methods for investigating sources of heterogeneity, and identification of moderator variables or effect modifiers. The investigation of sources of heterogeneity in meta-analysis is by nature exploratory, and therefore its results should always be interpreted with caution. However, careful investigation of heterogeneity may provide an important second level of evidence that can be useful in suggesting direction of future research. Sometimes, it may provide clinically important results by indicating who might benefit more or less from a treatment or how an intervention should be applied.
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