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Contact us About the company Clients The developers. Free Downloads The free trial installation will install a copy of the program and a PDF copy of the manual. RevMan 4. It stands out due to its extensive features for collaborative management of systematic reviews. The analytical functions of the program cannot be accessed without first creating a review structure and because import and copy-and-paste functionality are also limited, getting started requires more preparation than with most other software.

Once data are in the analysis module, analysis is straightforward. Output is detailed, though without tests for publication bias and no other graphs than the forest and funnel plot. The help resources in RevMan are extremely thorough. A new version is to be released in the near future. WEasyMA 2. Data cannot be imported or pasted and need to be entered manually, cell by cell. Another limitation of this program is that it can only handle data from clinical trials with dichotomous outcomes, e.

Although limited to these types of data, the program produces a wide variety of numerical and graphical output. The original author has indicated that the software is currently unsupported by a development team and may soon no longer be available.

Our internet and database search did not yield any publications on the validity or validation of any of the programs, except for MIX [24,]. Authors of all programs were contacted to determine whether yet unpublished evidence of validation procedures was available. Authors of RevMan indicated that validation data were made public via notes and abstracts at Cochrane Collaboration meetings and conferences. The authors of CMA, MetAnalysis, and MetaWin stated that all procedures had been checked extensively with external programs, spreadsheets, and occasionally by hand, though had not been made public.

For CMA, Excel sheets with such data are available upon request. We received no information on validation procedures from the authors of WEasyMA. In CMA, we found a small inconsistency in results of publication bias tests, but this was corrected via an update while we were writing this article. We did find what seemed to be a terminological inconsistency, as the Mantel-Haenszel labeled method used in MetaWin for odds ratio analyses gave results that were identical to those from Peto's method in the other programs albeit with confidence limits based on a t-distribution.

Since MetAnalysis and WEasyMA can only analyze data from two-by-two tables, the comparability assessments were limited to one data set []. We found that if we entered experimental group data first as is the case in all other software , an incorrect event coding is applied that causes the software to calculate risk differences and odds ratios of survival even if mortality is entered as event. For risk differences this only changes the sign, but for odds and odds ratios it gives the reciprocal of the intended results [26].

Although the book mentions that control data are to be entered in the first data column, the software has currently no built-in guard against this and we therefore urge users to be careful. In WEasyMA, we found results that could not be reproduced if a data set with zero events in one study arm was used. The WEasyMA authors did not respond to our inquiry into reasons for the discrepancies. Trouble with the electronic user form or installation of software made the data from 4 researchers incomplete and they were excluded from the quantitative part.

MIX scored highest on the overall usability 8. All scores are summary scores, based on the scores of items in the 'Installation', 'Data preparation', and 'Usability in analysis' categories.

Each item was scored from bad to excellent on a scale from 0 to RevMan was most familiar to the participating researchers. MIX had not been used by any of the participants but the name was familiar to some as they were affiliated to the same institutions as the makers of the MIX software. Stratifying the results in analogous subgroups did not reveal any specific trends in the ratings.

Experienced users appeared to be more critical than less experienced users, but relative scores were identical. Meta-analysis is an indispensable tool in current-day synthesis of research data from multiple studies, and systematic reviews with meta-analyses occupy the top position in the hierarchy of evidence. Software for meta-analysis has evolved over the years and available reviews are relatively outdated.

We therefore considered it timely to provide a systematic overview of the features, criterion validity, and usability of the currently available software that is dedicated to meta-analysis of causal therapeutic and etiologic studies. It has some overlaps with existing reviews [], but includes other more recent programs, contains more detailed information on the merits and demerits of the available programs, and follows a more systematic approach.

The features of the commercial programs were not necessarily more extensive than those of the free ones. In particular MIX stood out in terms of numerical options and graphical output. CMA was generally most versatile, in particular in options for analysis of various types of data. MetaWin's results are different and slightly more conservative, since the confidence intervals are based on a t-distribution or bootstraps.

WEasyMA produces results that can be disparate from the other programs, especially in data sets with studies with zero events in one or both of the comparison groups. Although most differences were small in the data sets we used, we have reservations on how this will reflect on data sets with more extreme data.

The MetAnalysis program should also be used with care as data have to be entered manually and in the correct columns. Exchanging the columns is currently not prevented by warning or error messages and can lead to invalid results.

The usability study shows that preparing data for analysis is the hardest part in each program. WEasyMA scored least favorable. Stratifying user evaluations based on experience with meta-analysis and previous experience or knowledge of the software did not reveal any trends in the ratings.

Our comparison has been limited to software dedicated to meta-analysis only and does not include general statistics packages. The primary reason to leave them out was because they are structurally very different, making direct comparisons inappropriate.

Central to this issue is software syntax: most general packages require thorough knowledge of their syntax in order to produce and alter graphs that are common in meta-analysis; the dedicated packages, however, produce such graphs with a few or sometimes even a single click.

In addition, the syntax knowledge required to do more advanced meta-analyses with the general packages means that in a usability survey all participants would have to be expert statisticians, capable of writing and adapting syntax for meta-analysis in all major general software packages. This is not only not feasible in the current setting, it would also make the participating individuals no longer representative of the sometimes relatively inexperienced users of the software in the scientific and academic community.

Although a different approach would be necessary, we believe the user community of meta-analysis software would benefit from an additional review of meta-analysis options in general statistics software. Due to the lack of a 'gold' standard, we resorted to between-program comparisons and a criterion validation with STATA's user-written commands metan , metabias and metatrim as reference. Our choice for STATA was based on its versatility and use in two major books on meta-analysis [11,12].

We realize that STATA itself is also user-written and potentially subject to similar validity issues than the other programs. The results of our usability survey should be regarded as exploratory and serve as a rough indication. First, the number of participants was relatively small. Second, it is not unlikely that there may be some bias in favor of RevMan and MIX because some users were already familiar with these programs. Subgroup analyses, however, did not reveal such trends.

MetAnalysis could unfortunately not be included as it was included after the start of the usability assessment. A further point regarding MIX is that it was created following a development focus list [] that was created in a similar fashion to our usability scoring list.