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Compared with trials of 1000 patients or more, treatment effects were, on average, 48% larger in trials with fewer than 50 patients (ratio of odds ratios 0.52, 0.41 to 0.66), 34% larger in trials with 50 99 patients (0.66, 0.56 to 0.79), 30% larger in trials with 100 199 patients (0.70, 0.61 to 0.80), 19% larger in trials with 200 499 patients (0.81, 0.73 to 0.88), and 10% larger in trials with 500 999 patients (0.90, 0.82 to 1.00; fig 1). Heterogeneity across meta analyses was moderate (2 ranged from 0.11 to 0.26).
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