Factors that influence effect size in 15O PET studies: a meta-analytic review

The PET literature is growing exponentially, creating a need and an opportunity to perform a meta-analytic review consolidating the published information. This study describes the use of effect size as an index in PET studies and discusses how this measure can be used for comparing findings across studies, laboratories, and paradigms. In comparing studies across laboratories it is essential to know how the methods employed affect the results and conclusions drawn. This study also compared effect size for two different methods of tracer delivery in 15O PET studies ([15O]H2O bolus injection versus inhalation of [15O]CO2), whether averaged versus single-scan conditions were used, and the data analytic strategy employed. The effect sizes observed across studies were consistently large with a median effect size of 8.55, indicating that the phenomena investigated in 15O PET studies are strong. The largest peak activation reported in a study was found to be affected by variability in sample size, data analytic strategy, and repeat versus single-scan conditions. However, the impact of these factors was not examined on smaller or less intense peaks. Minimal standards for reporting statistical results are discussed.