Reflections on the I-squared index for measuring inconsistency in meta-analysis

The I-squared index was proposed in 2002 as a measure to help understand the consistency of study results in a meta-analysis. It was developed to overcome some of the limitations of existing measures, principally the chi-squared test for heterogeneity and the between-study variance as estimated in a random-effects meta-analysis. I-squared measures approximately the proportion of total variability in results that is due to true heterogeneity rather than random error; it is also conveniently interpreted as a measure of inconsistency in the results of the studies. The index has become extremely widely used, although it is often misinterpreted as an absolute measure of the amount of heterogeneity, which it is not. Here, we discuss the I-squared index and the different ways it can be defined, computed, and interpreted. We introduce a new interpretation of I-squared as a weighted sum of squares, which we propose may be helpful when setting up simulation studies. We discuss some of the extensions and repurposes that have been proposed for I-squared and offer some recommendations on the appropriate use of the index in practice.