Meta-analysis - interpretation of forest plots: A wood for the trees

A forest plot is a graphical tool to visualise and interpret the summary of estimated results in a meta-analysis. However, it is limited by its inability to control for random error, publication bias, heterogeneity, and confounding factors. Therefore, the interpretation can be misleading, resulting...

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Main Authors: Soumya Sarkar, Dalim Kumar Baidya
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Indian Journal of Anaesthesia
Subjects:
Online Access:https://journals.lww.com/10.4103/ija.ija_1155_24
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author Soumya Sarkar
Dalim Kumar Baidya
author_facet Soumya Sarkar
Dalim Kumar Baidya
author_sort Soumya Sarkar
collection DOAJ
description A forest plot is a graphical tool to visualise and interpret the summary of estimated results in a meta-analysis. However, it is limited by its inability to control for random error, publication bias, heterogeneity, and confounding factors. Therefore, the interpretation can be misleading, resulting in flawed conclusions. A careful interpretation and other complementing techniques are necessary to comprehensively summarise evidence in meta-analyses, reducing the risk of erroneous conclusions. The present review explores the components of forest plots, how to interpret them correctly, fundamental limitations, and techniques to mitigate them, along with examples to provide practical insights to ensure more accurate and reliable meta-analytic results.
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institution Kabale University
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spelling doaj-art-6484f14a54e549918495de48252cbeec2025-02-06T05:26:09ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172025-01-0169114715210.4103/ija.ija_1155_24Meta-analysis - interpretation of forest plots: A wood for the treesSoumya SarkarDalim Kumar BaidyaA forest plot is a graphical tool to visualise and interpret the summary of estimated results in a meta-analysis. However, it is limited by its inability to control for random error, publication bias, heterogeneity, and confounding factors. Therefore, the interpretation can be misleading, resulting in flawed conclusions. A careful interpretation and other complementing techniques are necessary to comprehensively summarise evidence in meta-analyses, reducing the risk of erroneous conclusions. The present review explores the components of forest plots, how to interpret them correctly, fundamental limitations, and techniques to mitigate them, along with examples to provide practical insights to ensure more accurate and reliable meta-analytic results.https://journals.lww.com/10.4103/ija.ija_1155_24biasconfounding variablesforest plotheterogeneitymeta-analysis
spellingShingle Soumya Sarkar
Dalim Kumar Baidya
Meta-analysis - interpretation of forest plots: A wood for the trees
Indian Journal of Anaesthesia
bias
confounding variables
forest plot
heterogeneity
meta-analysis
title Meta-analysis - interpretation of forest plots: A wood for the trees
title_full Meta-analysis - interpretation of forest plots: A wood for the trees
title_fullStr Meta-analysis - interpretation of forest plots: A wood for the trees
title_full_unstemmed Meta-analysis - interpretation of forest plots: A wood for the trees
title_short Meta-analysis - interpretation of forest plots: A wood for the trees
title_sort meta analysis interpretation of forest plots a wood for the trees
topic bias
confounding variables
forest plot
heterogeneity
meta-analysis
url https://journals.lww.com/10.4103/ija.ija_1155_24
work_keys_str_mv AT soumyasarkar metaanalysisinterpretationofforestplotsawoodforthetrees
AT dalimkumarbaidya metaanalysisinterpretationofforestplotsawoodforthetrees