I would appreciate it if someone could advise on meta-analsyis approach below.
I’m undertaking a systematic review of the association between incident TB and COPD.
We included 3 cohort papers and as you see in the figure the point estimates are heterogeneous (I-squared=97.04%) but the direction of estimates are consistent and all are statistically significant.
In terms of clinical characteristics, they are somewhat heterogeneous. One study included included only hospital discharged COPD cases and another included only patients with pre-dialysis CKD.
In the primary analysis, I applied the Hartung-Knapp method to account for uncertainty in between-study heterogeneity. This resulted in a wide CI and non-significant result despite individual studies suggesting significant results.
I think this is due to a small number of studies, which leads to a wide uncertainty in between-study heterogeneity. In contrast, the one at the bottom using a conventional method showed a significant result. I’m wondering how to deal with the situation.
I’m inclined to sticking to the HK method and also discussing qualitatively.
Thank you for your advice in advance.