📑 Table of Contents

RevMan (Review Manager) is the official software developed by Cochrane for conducting systematic reviews and meta-analyses. It is widely used in medical research to pool results from multiple studies, create forest plots, and assess risk of bias. This guide walks you through using RevMan from installation to final analysis.

What is RevMan?

RevMan is free software developed by the Cochrane Collaboration for preparing and maintaining Cochrane systematic reviews. It is also widely used for non-Cochrane systematic reviews and meta-analyses in medical research.

  • Free to download from the Cochrane website
  • Allows structured data entry, analysis, and reporting
  • Automatically generates forest plots and summary statistics
  • Includes risk of bias assessment tool
  • Output compatible with Cochrane Review Group requirements
  • Available for Windows, Mac, and Linux

Installation & Setup

  • Download RevMan 5 (desktop) or use RevMan Web (browser-based)
  • RevMan Web: Access at revman.cochrane.org — requires free Cochrane account
  • RevMan 5 desktop: Download from cochrane.org/revman — no login required
  • System requirements: Windows 7+, Mac OS X 10.9+, Java 8+
  • Create a new review using File → New → Intervention Review or Diagnostic Test Accuracy Review
  • Set up review sections: Background, Objectives, Methods, Results, Discussion
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Data Entry in RevMan

Data entry in RevMan depends on the type of outcome data you are pooling.

  • Dichotomous data: Enter number of events and total participants for each group (e.g., deaths: 15/100 vs 25/100)
  • Continuous data: Enter mean, standard deviation, and sample size for each group
  • Generic inverse variance: For pre-calculated effect sizes (log OR, hazard ratios)
  • Each study is entered as a separate row in the data table
  • Enter year, author name, and unique study ID for each study
  • Double-check extracted data against original papers before analysis

Creating Forest Plots

Forest plots visually display the results of each study and the pooled estimate. RevMan generates these automatically from your data.

  • Each horizontal line represents one study; length = confidence interval width
  • Box size represents study weight (larger box = larger study)
  • Diamond at bottom = pooled effect estimate and its CI
  • Vertical line at 1.0 (or 0 for mean difference) = line of no effect
  • Choose between Fixed Effect and Random Effects model
  • Random Effects model preferred when heterogeneity is present (I² > 50%)
  • Export forest plots as high-resolution images for journal submission

Risk of Bias Assessment

RevMan includes the Cochrane Risk of Bias tool for assessing methodological quality of included studies.

  • RoB 2 (for RCTs) assesses: randomization, allocation concealment, blinding, missing data, measurement bias, selective reporting
  • ROBINS-I (for non-randomized studies) assesses similar domains
  • Each domain rated: Low risk, Some concerns, High risk
  • RevMan generates traffic light summary tables and bar charts
  • At least two independent reviewers should assess risk of bias
  • Calculate inter-rater agreement using Cohen's kappa
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Understanding Heterogeneity

  • I² statistic: Measures percentage of variability due to heterogeneity (0-100%)
  • I² < 25%: Low heterogeneity — Fixed Effect model acceptable
  • I² 25-50%: Moderate heterogeneity — consider subgroup analysis
  • I² > 50%: High heterogeneity — Random Effects model preferred; investigate sources
  • Q test (Cochran's Q): Tests if heterogeneity is statistically significant (p < 0.10)
  • Investigate heterogeneity through subgroup analysis (by age, study design, dose)
  • Sensitivity analysis: remove one study at a time and re-run analysis

RevMan vs Alternatives

  • RevMan: Free, Cochrane standard, good for clinical reviews
  • R (meta package): Free, more flexibility, requires coding knowledge
  • Stata: Paid, powerful meta-analysis commands (metan, metareg)
  • Comprehensive Meta-Analysis (CMA): User-friendly, paid software
  • MetaXL: Excel-based, free, good for beginners
  • For Cochrane reviews: RevMan is mandatory
  • For non-Cochrane journal publications: any validated software is acceptable

❓ Frequently Asked Questions

Quick answers to common questions about using RevMan software for meta-analysis

Yes, RevMan 5 desktop software is free to download from the Cochrane website. RevMan Web (browser-based version) requires a free Cochrane account. Both versions are freely available for researchers worldwide.

RevMan handles dichotomous data (events vs non-events), continuous data (means and standard deviations), and generic inverse variance data (pre-calculated effect sizes). It can analyze outcomes for both RCTs and non-randomized studies depending on the review type selected.

Use Fixed Effect model when studies are very similar (low heterogeneity, I² < 25%) and you assume a single true effect size. Use Random Effects model when studies vary in population, intervention, or setting (I² > 25-50%), as it accounts for between-study variability and is generally more conservative.

Technically you can pool as few as 2 studies, but most journals require a minimum of 5-10 studies for a meaningful meta-analysis. With fewer studies, heterogeneity estimates are unreliable and results may be unstable. Focus on comprehensive literature search to maximize included studies.

Yes, RevMan 5.4+ includes a Diagnostic Test Accuracy (DTA) review format. It can analyze sensitivity, specificity, and generate SROC (Summary ROC) curves. You need to enter 2x2 contingency tables (TP, FP, FN, TN) for each study from your DTA review.