Fixed-effect and random-effects models in meta-analysis

Saudi Board of Preventive Medicine, Riyadh Ministry of Health, KSA Lecture 06/10
Dr. S. A. Rizwan, M.D.Demystifying statistics series: Meta-analysis course
Fixed-effect vs. Random-effects
models in meta-analysis
Dr. S. A. Rizwan M.D.,
Public Health Specialist & Lecturer,
Saudi Board of Preventive Medicine – Riyadh,
Ministry of Health, KSA
25.11.2019 1
With thanks to Michael Borenstein

Outline
• Provide a description of fixed and of random effects models
• Outline the underlying assumptions of these two models in order to
clarify the choices a reviewer has in a meta-analysis
• Discuss how to estimate key parameters in the model
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Our choice between the two depends on
• Our assumption about how the effect sizes vary in our meta-analysis
• The two models are based on different assumptions about the nature
of the variation among effect sizes in our research synthesis
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Sampling assumptions
• Fixed-effect
• Sampling takes place at one level only
• Any between-study variance will be ignored when assigning weights
• Random-effects
• Sampling takes place at two levels
• Any between-study variance will be used when assigning weights
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Fixed-effect
• When there is reason to believe that all the studies are functionally identical
• When our goal is to compute the common effect size, for the studies in the
analysis
• Example of drug company has run five studies to assess the effect of a drug
• Note that the effect size from each study estimate a single common mean –
the fixed-effect
• We know that each study will give us a different effect size, but each effect
size is an estimate of a common mean, designated in the prior picture as θ
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Dr. S. A. Rizwan, M.D.Demystifying statistics series: Meta-analysis course 25.11.2019 6

Random-effects
• We assume two components of variation:
• – Sampling variation as in our fixed-effect model assumption
• – Random variation because the effect sizes themselves are sampled from
population of effect sizes
• In a random effects model, we know that our effect sizes will differ
because they are sampled from an unknown distribution
• Our goal in the analysis will be to estimate the mean and variance of
the underlying population of effect sizes
• All the studies are functionally equivalent
• Example of studies culled from publications
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Random-effects
• We see in the picture that each distribution has its own mean that is
sampled from the underlying population distribution of effect sizes
• That underlying population distribution also has its own variance, τ2,
commonly called the variance component
• Thus, each effect size has two components of variation, one due to
sampling error, and one from the underlying distribution
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Definition of combined effect
• Fixed effect model
• There is one true effect
• Summary effect is estimate of this value
• Random effects model
• There is a distribution of effects
• Summary effect is mean of distribution
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How weights are assigned?
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W = 1/ (V1)
Fixed-effects model
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Random-effects model
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1W = 1/ (V +T 2
)

190
How weights shift?
• If within-study variance only, W=1/V
• If between-study variance only, W=1/T2
• If both, W=1/(V+T2)
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Random vs. Fixed
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Random vs. Fixed
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RE weights are more balanced

Random vs. Fixed
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RE confidence interval is wider

Large study has less impact under RE
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Small study has more impact under RE
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FE
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Summary effect in Fixed model
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244.215
101.171
= 0.414FE

Variance of summary effect in fixed model
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1
244.215
= 0.004FE

RE
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Summary effect in random model
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90.284
32.342
= 0.358RE

Variance of summary effect in random model
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1
90.284
= 0.011RE

Why does it matter?
• One matches the sampling
• One does not match the sampling
• Wrong model yields incorrect weights
• Estimate of mean is wrong
• Estimate of CI is wrong
• MUST choose based on sampling model
• The meaning of the ES is different
• Relative weights are closer under RE (effect size will shift)
• Absolute weights are smaller under RE (CI will become wider)
• p-value will change (less significant in long run but can go either way)
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Test of null
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M
M
Z =
SE
M*
M*
Z* =
SE
Fixed
Random
Two
sources
of error
One
source
of error

Implications of the choice
• If you expect that the effect size from each study arises from a different
population then use random effects
• Random effects model is more likely to give non-significant estimates
• Recall that all our analyses in a meta-analysis are weighted by the inverse of
the variance of the effect size, i.e., by the precision of the effect size estimate
• Because we have more variation assumed in a random effects model, our
weights for each study will be more equal to one another
• In other words, in a fixed effect model, we will more heavily weight larger
studies. In a random effects model, the larger studies will not be weighted as
heavily
25.11.2019 30

Question!
• Suppose we had four studies, each with
• N =1,000,000, and a true (mean) effect size of 50.
• Under the two models,
• What would the forest plot look like?
• What would the diamond look like?
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Which model should we use?
• Base decision on the model that matched the way the data were
collected
• Not on test of homogeneity
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What you may hear
• Fixed-effect is simple model
• Random-effects is more complicated
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Actually
• Fixed-effect is more restricted model
• Random-effects makes less assumptions
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An alternate view
• Random-effects model only makes sense if we have a clear picture of
the sampling frame
• Otherwise, we should report the mean and CI for the studies in our
sample without attempt to generalize to a larger universe
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Goals in a fixed effect model
• In a fixed effect model, we will be most interested in estimating our
common effect, θ, and its standard error
• We will also want to know if there is heterogeneity present by
computing Q
• HOWEVER, WE WILL NOT decide on the basis of a significant Q that
we should really do a random effects model
• WE WILL make a decision about fixed effect versus random effects
models because of our substantive knowledge of the area of the
systematic review
25.11.2019 38

Goals in a random effects model
• We also want to estimate a mean effect size, but now this is the mean
effect size from the underlying population, μ
• We also want to estimate the variance of the underlying effect size, τ2
• We will test heterogeneity by testing whether τ2 is different from 0.
• Biggest difficulty: how to estimate τ2
25.11.2019 39

Estimating the variance component, τ2
• There are two main methods for computing τ2
• Variously called the method of moments, the DerSimonian/Laird estimate
• Restricted maximum likelihood
• The method of moments estimator is easy to compute and is based
on the value of Q, the homogeneity statistic
• Restricted maximum likelihood requires an iterative solution
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Method of moments estimator
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Restricted maximum likelihood estimator
• Many statisticians do not like the method of moments estimator
• Can estimate τ2 using HLM, SAS Proc Mixed, or R
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Differences between the two
models
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ES assumptions
Fixed effect model
• We assume that the treatment
effect is the same in all trials.
• We use only the sampling
variation within the trials.
Random effects model
• We assume that the treatment
effect is the not same in all trials.
• The trials are a sample from a
population of possible of trials
where the treatment effect varies.
• We use the sampling variation
within the trials and the sampling
variation between trials.
25.11.2019 44

Sampling assumptions
Fixed effect model
• If the treatment effect is the
same in all trials, it is more
powerful and easier.
• No assumption about
representativeness.
• Less powerful because P values are
larger and confidence intervals are
wider.
• The trials are a sample from a
population of possible of trials
where the treatment effect varies.
• They must be a representative or
random sample.
• Very strong assumption.
25.11.2019 45

Variance
Fixed effect model
• Variance of treatment effect in
trial = standard error squared.
• Weight = 1/variance = 1/SE2
• Variance of treatment effect in trial
= standard error squared plus inter-
trial variance
• Weight = 1/variance.
• 1
= --------------------------------
SE2 + inter-trial variance
• Inter-trial variance has degrees of
freedom given by number of trials
minus one.
• Typically small.
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When heterogeneity exists
Fixed effect model
• When heterogeneity exists we
get:
• a pooled estimate which may give
too much weight to large studies,
• a confidence interval which is too
narrow,
• a P-value which is too small.
• When heterogeneity exists we
get:
• possibly a different pooled
estimate with a different
interpretation,
• a wider confidence interval,
• a larger P-value.
25.11.2019 47

When heterogeneity doesn’t exist
Fixed effect model
• When heterogeneity does not
exists:
• a pooled estimate which is
correct,
• a confidence interval which is
correct,
• a P-value which is correct.
• When heterogeneity does not
exist:
• a pooled estimate which is
correct,
• a confidence interval which is too
wide,
• a P-value which is too large.
25.11.2019 48

Thank you
Kindly email your queries to sarizwan1986@outlook.com
25.11.2019 50

Fixed-effect and random-effects models in meta-analysis

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