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In a recent meta-analysis by Laudy et al,1 the authors used a fixed-effects model when there was significant heterogeneity for Western Ontario and McMaster Universities Osteoarthritis (WOMAC) knee pain (refer to figure 11 of the article, χ2=17.12, I2=94%, p<0.0001) and WOMAC physical function (refer to figure 13 of the article, χ2=16.40, I2=94%, p<0.0001), and stated that platelet-rich plasma (PRP) reduced pain and improved function more effectively than hyaluronic acid (HA).
Fixed-effects and random-effects models are the most commonly used statistical methods for meta-analysis, and systematic reviewers often need to choose one of the two models. In the presence of small heterogeneity, the fixed-effects model is more appropriate, while it inclines to the random-effects model when heterogeneity is large. Thus, dealing with heterogeneity is one of the most challenging tasks in meta-analysis.
Although I2 statistics are considered good indicators for assessing heterogeneity,2 it has been found that the test has poor …
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