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For independent two-by-two tables with counts $a_i,b_i,c_i,d_i$ and total $n_i$, the Mantel–Haenszel pooled odds ratio is the displayed ratio of sums. When all $b_i{c}_i>0$, it is also the weighted arithmetic mean of study odds ratios with weights $b_i{c}_i/n_i$. These differ from inverse estimated variance weights for log odds ratios. Both constructions can represent a fixed-effect meta-analysis, but they should not be silently interchanged when interpreting a supplied plot.

A fixed-effect meta-analysis models the studies as estimating a common underlying treatment effect. In a generic inverse-variance version, independent log odds ratios $y_i$ have approximate distributions $N(\delta ,v_i)$ and are pooled with weights $1/v_i$. The supplied forest plot instead has the Mantel–Haenszel pooled odds ratio weights: for event/nonevent cells $a_i,b_i,c_i,d_i$ and total $n_i$, the normalized weights are proportional to $b_i{c}_i/n_i$. They reproduce the printed percentages and yield a pooled odds ratio about $2.338$. This is still a common-effect analysis; the two weighting methods should not be silently identified.

A random-effects meta-analysis allows different true effects: $y_i\mid {\delta }_i\sim N({\delta }_i,v_i)$ with ${\delta }_i\sim N(\mu ,{\tau }^2)$. The between-study heterogeneity variance ${\tau }^2$ adds to sampling variance, giving marginal variance $v_i+{\tau }^2$. Its pooled estimate targets the mean of the study-effect distribution rather than one identical effect. Uncertainty about heterogeneity must also be considered.

Let $y_i$ be each trial's estimated log risk ratio, with estimated sampling variance $s_i^2$. A fixed-effect meta-analysis models the independent estimates as $y_i\simeq N(\mu ,s_i^2)$, with one common true log risk ratio $\mu$. Differentiating the Gaussian log-likelihood, or minimizing ${\sum }_i(y_i-\mu {)}^2/s_i^2$, gives inverse-variance weights $w_i=1/s_i^2$ andThe variance follows directly by adding independent variances of the weighted estimates: ${\sum }_i{w}_i^2{s}_i^2/({\sum }_i{w}_i{)}^2=1/{\sum }_i{w}_i$.

Using the printed rounded estimates and standard errors, ${\sum }_i{w}_i=50.2923$, soThe pooled risk ratio is about $0.902$. An interval using the same quantile two is $(-0.3848,0.1792)$ on the log scale, so it includes no effect. Recomputing all trial estimates from the event counts would change the last digits because the printed log estimates and errors are rounded.

The key assumptions are independent trials, a common true treatment effect on this chosen log scale, approximately unbiased and approximately normal trial estimates, and suitable sampling-variance estimates. The common-effect assumption is stronger than merely studying the same named treatment: systematic population, treatment or design differences may produce genuine heterogeneity. For an unbiased interpretation of the pooled evidence, inclusion of studies must also not depend selectively on their results. Treating the plug-in variances as fixed is the usual approximation in the displayed variance formula.

A fixed-effect meta-analysis assigns inverse-variance weights. Using the unrounded within-study variance from part (b), this trial has $w=8$, so its percentage weight isUsing the printed rounded standard error of $0.35$ instead gives approximately $2.04\%$; the raw cell calculation yields the more precise answer.

For a random-effects meta-analysis, the corresponding weight and percentage weight areWith ${\hat{\tau }}^2=0.05$, its unnormalised weight is $40/7\approx 5.714$. The supplied sums of fixed-effect weights do not determine the denominator of the random-effects percentage; the individual $v_i$ are needed. Positive heterogeneity makes the weight distribution more even. Percentage weight measures the trial's contribution to a pooled mean with fixed weights; total influence can also involve re-estimation of heterogeneity.