Meta-Analysis in RevMan (Review Manager): A Practical Guide with Case Studies on Continuous and Dichotomous Data

Meta-Analysis in RevMan (Review Manager): A Practical Guide with Case Studies on Continuous and Dichotomous Data

Part A: Meta Analysis for Continuous Data:

Case Study 1:

Research Question

Does physical activity improve self-esteem in adolescents compared to no intervention?

Data:

Study ID	Sample Size (Exercise Group)	Mean Self-Esteem (Exercise Group)	SD (Exercise Group)	Sample Size (Control Group)	Mean Self-Esteem (Control Group)	SD (Control Group)
Study 1	60	31.2	5.5	60	27.8	5.6
Study 2	75	32.5	6	75	29	6.2
Study 3	50	30.4	5.2	50	27.5	5.5
Study 4	80	33	5.8	80	29.5	6
Study 5	65	31.8	5.6	65	28.6	5.7
Study 6	90	34	6.1	90	30	6.4
Study 7	55	30.5	5.9	55	27.2	6
Study 8	100	33.8	6.3	100	29.9	6.6
Study 9	70	32	5.7	70	28.5	5.9
Study 10	85	33.1	6.2	85	29.6	6.5

Data Description:

The dataset includes summary statistics from 10 studies comparing self-esteem scores between exercise and control groups, each providing sample size, mean, and standard deviation.

Step by Step Meta Analysis for Continuous data in RevMan:

Step 1: Add Included Studies, Select Studies and References Section then Click on Add Study to enter each individual Study and Year.

All 10 Studies Included:

Step 3: Click on Data Analysis Tab then Add Comparison insert Outcome Name and choose Continuous Outcome.

Step 4: Select Model (Random Effect) and Effect Measure (Standardized Mean Difference).

Step 5: Enter Data For each study, enter: Mean, Standard Deviation (SD) and Total Sample Size in each group (for both Treatment and control).

Step 6: To Generate Forest Plot, Click on Figure tab then Add Figure and Click Forest Plot, then Click Next and Select outcome thenclick on Finish.

Forest Plot:

Interpretation:

All studies report positive SMDs (0.54 to 0.64), showing a consistent moderate effect of physical activity on self-esteem. None of the confidence intervals cross zero, indicating each study found a statistically significant result. The overall pooled effect is [latex]0.58 [95% CI: 0.48, 0.69][/latex], confirming a moderate and meaningful improvement in self-esteem. Heterogeneity is absent [latex](τ² = 0.00, I² = 0%, Chi² = 0.3, p = 1.00)[/latex], suggesting highly consistent findings across studies. The overall effect is statistically significant [latex](z = 10.98, p < 0.00001)[/latex], providing strong evidence for the positive impact of physical activity on adolescent self-esteem.

Step 7: To Generate Funnel Plot, Click on Figure tab then Add Figure and Click Funnel Plot, then Click Next and Select outcome thenclick on Finish.

Funnel Plot:

Interpretation:

The studies are symmetrically scattered around the pooled SMD (0.58), indicating no visual evidence of publication bias.

Part B: Meta Analysis for Dichotomous Data:

Case Study 2:

Research Question:

Does Drug A reduce the risk of infection compared to Placebo?

Data

Study ID	Drug A Events	Drug A No Events	Drug A Total	Placebo Events	Placebo No Events	Placebo Total
Study 1	12	90	102	25	79	104
Study 2	18	84	102	30	73	103
Study 3	10	90	100	20	80	100
Study 4	8	94	102	16	86	102
Study 5	20	82	102	35	70	105
Study 6	15	85	100	28	78	106
Study 7	17	85	102	33	68	101
Study 8	13	89	102	27	80	107
Study 9	19	70	89	31	70	101
Study 10	14	86	100	26	80	106

Data Description:

The dataset includes results from 10 studies comparing infection rates between patients receiving Drug A and those receiving a placebo. Each study reports the number of infection events and non-events in both groups as well as Total enabling the calculation of risk Differences.

Step by Step Meta Analysis for Dichotomous data in RevMan:

Step 1: Add Included Studies, Select Studies and References Section then Click on Add Study to enter each individual Study and Year.

All 10 Studies Included:

Step 3: Click on Data Analysis Tab then Add Comparison insert Outcome Name and choose Continuous Outcome.

Step 4: Select Model (Random Effect) and Effect Measure (Risk Difference).

Step 5: Enter Data For each study, enter: Event and Total for Treatment and Control Group.

Step 6: To Generate Forest Plot, Click on Figure tab then Add Figure and Click Forest Plot, then Click Next and Select outcome thenclick on Finish.

Forest Plot:

Interpretation:

The meta-analysis shows a pooled risk difference of[latex] -0.11 [95% CI: -0.15, -0.08][/latex], indicating Drug A reduces risk by 11% compared to placebo. All individual studies have negative risk differences, favouring Drug A, with several confidence intervals not crossing zero. Heterogeneity is very low [latex](I² = 0%)[/latex], suggesting consistent results across studies. The overall effect is statistically significant [latex](p < 0.00001)[/latex]. The forest plot confirms the consistent beneficial effect of Drug A across all 10 studies.

Step 7: To Generate Funnel Plot, Click on Figure tab then Add Figure and Click Funnel Plot, then Click Next and Select outcome thenclick on Finish.

Funnel Plot:

Interpretation:

The studies are symmetrically scattered around the pooled Risk Difference (-0.11), indicating no visual evidence of publication bias.