Metaplot: A new Stata module for assessing heterogeneity in a meta-analysis

BACKGROUND: The proposed sequential and combinatorial algorithm, suggested as a standard tool for assessing, exploring, and reporting heterogeneity in the meta-analysis, is useful but time-consuming particularly when the number of included studies is large. Metaplot is a novel graphical approach that facilitates performing sensitivity analysis to distinguish the source of substantial heterogeneity across studies with ease and speed. METHOD: Metaplot is a Stata module based on Stata’s commands, known informally as "ado". Metaplot presents a two-way (x, y) plot in which the x-axis represents the study codes and the y-axis represents the values of I(2) statistics excluding one study at a time (n-1 studies). Metaplot also produces a table in the ’Results window’ of the Stata software including details such as I(2) and χ(2) statistics and their P-values omitting one study in each turn. RESULTS: Metaplot allows rapid identification of studies that have a disproportionate impact on heterogeneity across studies, and communicates to what extent omission of that study may reduce the overall heterogeneity based on the I(2) and χ(2) statistics. Metaplot has no limitations regarding the number of studies or types of outcome data (binomial or continuous data). CONCLUSIONS: Metaplot is a simple graphical approach that gives a quick and easy identification of the studies having substantial influences on overall heterogeneity at a glance.