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February 24, 2026Indian Journal of Psychiatry0 citationsOpen Access

Intraclass correlation in cluster randomized controlled trials for anxiety disorders: Evidence from a meta-analysis

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BBBinukumar BhaskarapillaiPMPalash Kumar MaloMKM Thomas Kishore

Key Points

  • This meta-analysis aims to estimate the pooled intraclass correlation coefficient (ICC) for cluster randomized trials focused on anxiety disorders.
  • Conducted a systematic search across multiple databases to identify relevant studies.
  • Included 23 studies in the meta-analysis after screening 1,124 citations.
  • Used DerSimonian and Laird’s inverse variance method for pooled ICC calculations.
  • Pooled ICC for the studies was found to be 0.05 (95% CI: 0.04–0.06) indicating minimal correlation.
  • 16 out of 23 studies reported ICCs at the design stage, showing no significant difference from post-intervention ICCs.
  • Noted substantial heterogeneity in results and suggested publication bias.

Abstract

Background: Cluster randomized trials (CRTs) reduce intervention contamination but may compromise statistical efficiency. Although Consolidated Standards of Reporting Trials (CONSORT) guidelines recommend reporting intraclass correlation coefficients (ICCs), compliance is limited. Aim: This meta-analysis attempts to estimate the pooled ICC of CRTs on anxiety disorders. Results: A systematic search in various databases yielded 1,124 citations, qualifying 23 studies for meta-analysis upon further screening. DerSimonian and Laird’s inverse variance method was used to calculate the pooled estimates. Among 23 studies, 16 reported ICCs at the design stage, with no significant difference compared to post-intervention values. The pooled ICC was 0.05 (95% CI: 0.04–0.06) with substantial heterogeneity; funnel plot asymmetry suggested publication bias, though Egger’s test found no small-study effects ( P = 0.913). Conclusion: Only two-thirds of CRTs on anxiety disorders complied with CONSORT recommendations on ICC reporting. The pooled ICC from this meta-analysis provides a reference for sample size estimations in future CRTs targeting anxiety disorders.

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Cite This Study

Bhaskarapillai et al. (2026) studied this question.

synapsesocial.com/papers/699d3f9ede8e28729cf6451ehttps://doi.org/10.4103/indianjpsychiatry_915_25
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