Assessment of Heterogeneity in Heart Failure-Related Meta-Analyses

Muhammad Shahzeb Khan, Lin Li, Farah Yasmin, Safi U. Khan, Navkaranbir S. Bajaj, Ambarish Pandey, M. Hassan Murad, Gregg C. Fonarow, Javed Butler, Muthiah Vaduganathan

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


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: (I2=0%), 40 outcomes (9.5%) had low heterogeneity (I2<25%), 76 outcomes (18%) had moderate heterogeneity (I2=25%-50%), and 169 outcomes (40%) had high heterogeneity (I2>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.

Original languageEnglish (US)
Pages (from-to)E007070
JournalCirculation: Heart Failure
Issue number11
StatePublished - Nov 1 2020


  • evidence-based medicine
  • heart failure
  • patients
  • population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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