Assessment of Heterogeneity in Heart Failure–Related Meta-Analyses. (November 2020)

• Record Type: Journal Article
• Authors: Khan, Muhammad Shahzeb; Li, Lin; Yasmin, Farah; Khan, Safi U.; Bajaj, Navkaranbir S.; Pandey, Ambarish; Murad, M. Hassan; Fonarow, Gregg C.; Butler, Javed; Vaduganathan, Muthiah
• Is Part Of: Circulation. Volume 13:Number 11(2020)
• Publication Date: 2020-11
• Subjects: evidence-based medicine -- heart failure -- patients -- population; Heart failure -- Periodicals; 616.129005
• DOI: 10.1161/CIRCHEARTFAILURE.120.007070
• Languages: English
• ISSNs: 1941-3289

Abstract

Abstract : Background: Assessment of heterogeneity in meta-analyses is critical to ensure the consistency of pooled results. Therefore, we sought to assess the evaluation and reporting of heterogeneity in heart failure (HF) meta-analyses. Methods: Study level meta-analyses pertaining to HF were selected from January 2009 to July 2019, published in 11 high impact factor journals. We tabulated the overall proportion of the meta-analyses reporting statistical heterogeneity and specific metrics and methods employed to quantify and explore heterogeneity. Results: Of 126 HF meta-analyses (612 outcomes), heterogeneity was reported for 422 outcomes (68.9 %) in 108 meta-analyses. Out of the 422 outcomes reporting statistical heterogeneity, 137 outcomes (32.5%) had no observable heterogeneity: ( I 2 =0%), 40 outcomes (9.5%) had low heterogeneity ( I 2 <25%), 76 outcomes (18%) had moderate heterogeneity ( I 2 =25%–50%), and 169 outcomes (40%) had high heterogeneity ( I 2 >50%). Reporting of statistical heterogeneity was not significantly associated with year of publication, funding source, disclosure information, or the type of studies pooled. Sensitivity analysis (n=68) was the most common statistical technique employed to evaluate the source of heterogeneity followed by subgroup analyses (n=59) and meta-regression (n=40). Conclusions: Despite being an essential component of meta-analyses, heterogeneity was not reported for nearly 30% of outcomes and variably handled in contemporary HF meta-analyses. As meta-analyses increase across HF science, interpreting and handling of heterogeneity should be standardized. Abstract : Supplemental Digital Content is available in the text.