ArticleJournal of epidemiology2022
Meta-analysis Using Flexible Random-effects Distribution Models.
Article in Journal of epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Meta-analysis models relaxing the random-effects normality assumption: methodological systematic review and simulation study.BMC medical research methodology · 2025Pooled it
- Logistic Mixed-Effects Model Analysis With Pseudo-Observations for Estimating Risk Ratios in Clustered Binary Data Analysis.Statistics in medicine · 2025Article
- A novel robust meta-analysis model using theResearch synthesis methods · 2025Article
- Article
- Adverse pregnancy outcomes in gestational diabetes mellitus: a systematic review and meta-analysis protocol.BMJ open · 2024Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn meta-analysis, the normal distribution assumption has been adopted in most systematic reviews of random-effects distribution models due to its computational and conceptual simplicity. However, this restrictive model assumption is possibly unsuitable and might have serious influences in practices.
methodsWe provide two examples of real-world evidence that clearly show that the normal distribution assumption is explicitly unsuitable. We propose new random-effects meta-analysis methods using five flexible random-effects distribution models that can flexibly regulate skewness, kurtosis and tailweight: skew normal distribution, skew t-distribution, asymmetric Subbotin distribution, Jones-Faddy distribution, and sinh-arcsinh distribution. We also developed a statistical package, flexmeta, that can easily perform these methods.
resultsUsing the flexible random-effects distribution models, the results of the two meta-analyses were markedly altered, potentially influencing the overall conclusions of these systematic reviews.
conclusionThe restrictive normal distribution assumption in the random-effects model can yield misleading conclusions. The proposed flexible methods can provide more precise conclusions in systematic reviews.
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