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Ottone, Nicolás Ernesto

https://orcid.org/0000-0002-3056-9703

Mayo Clinic

Universidad de La Frontera

Citations 2

Extreme Heterogeneity Reported in Published Anatomical Meta‐Analyses: A Meta‐Epidemiological Study
IWANAGA, Joe, Walocha, Jerzy, Ottone, Nicolás Ernesto , Loukas, Marios , Tubbs, R. Shane, Ottone, Nicolás E , Iwanaga, Joe , Walocha, Jerzy Andrzej

Clinical Anatomy | July 8, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available

10.1002/ca.70180 Get It

ABSTRACT Following the introduction of meta‐analytic methodology into anatomical research, anatomical meta‐analyses have increased substantially. However, extremely high statistical heterogeneity is frequently observed in these studies, while its implications remain insufficiently discussed within anatomical research. The present study investigated the current state and patterns of heterogeneity in anatomical meta‐analyses and explored the interpretive implications of heterogeneity in anatomical evidence synthesis. A PubMed search was performed on May 21, 2026, using the title‐based search strategy: ((meta‐analysis[Title]) OR (meta analysis[Title])) AND (anatomy[Title]). Anatomical meta‐analyses focused on human structural anatomy were included. Reported I 2 values were extracted and descriptively analyzed by overall distribution and anatomical category. A total of 132 studies were identified, of which 61 anatomical meta‐analyses with analyzable heterogeneity data were included. The mean reported I 2 value was 95.27% (range 41%–100%), with a median I 2 of 98.77%. Most studies demonstrated extreme heterogeneity, with 86.9% reporting I 2 values exceeding 90%. Category‐specific analysis demonstrated consistently elevated heterogeneity across anatomical systems, including skeletal structures (mean I 2 = 99%), peripheral nerves (mean I 2 = 95%), and vascular anatomy studies (mean I 2 = 94.56%). Despite this, pooled prevalence estimates were frequently reported with highly precise numerical values and narrow confidence intervals. Extreme statistical heterogeneity is highly prevalent across anatomical meta‐analyses and appears to represent a widespread characteristic of anatomical synthesis research rather than an isolated statistical phenomenon. Although such heterogeneity likely reflects genuine biological and methodological variability, pooled anatomical estimates should be interpreted with caution, particularly when highly precise numerical estimates are reported despite substantial interstudy inconsistency. These findings highlight the importance of transparent heterogeneity reporting and anatomically stratified approaches in future anatomical meta‐analyses.
Ethical Use of Cadaveric Images in Anatomical Textbooks, Atlases, and Journals: A Consensus Response From Authors and Editors
Kim, Hee‐Jin , Logan, Bari M., Hutchings, R. T., Anand, Mahindra , Burns, Danny, Singh, Vishram, Peris‐Celda, Maria , Martı́nez-Soriano, Francisco, Apaydın, Nihal, Hanna, Amgad S. , Yoshioka, Nobutaka , Fernandez‐Miranda, Juan C. , Saremi, Farhood , Spratt, Jonathan D., Ho, Siew Yen , Mori, Shumpei , Komune, Noritaka , Watanabe, Koichi , Abrahams, Peter, Ibaragi, Soichiro , Loukas, Marios , Tubbs, R. Shane, Kim, Hee-Jin , Hur, Mi-Sun , Reina, Francisco , Tabira, Yoko , Carrera, Anna , Komune, Noritaka , Watanabe, Koichi , Reina, Miguel Angel , Loukas, Marios , Iwanaga, Joe , Akita, Keiichi , Ottone, Nicolás Ernesto , Nonaka, Yoichi , Shoja, Mohammadali M. , Tabira, Yoko , Prats‐Galino, Alberto , Andrés, José De , Reina, Miguel Ángel , Anderson, Robert Henry

Clinical Anatomy | January 4, 2025 | Volume: 38 | Issue: 2 | Pages: 222-225

10.1002/ca.24258 Get It

ABSTRACT Nowadays, consent to use donor bodies for medical education and research is obtained from the body donors and their families before the donation. Recently, the International Federation of Associations of Anatomists (IFAA) published guidelines that could restrict the appearance of cadaveric images in commercial anatomical resources such as textbooks and other educational products. These guidelines state that the donor must expressly consent to using such images for this purpose. Cadaveric photos and drawings made from dissections of cadavers have been used in anatomy textbooks and atlases for hundreds of years. They are invaluable for anatomy students and clinical/surgical practitioners. The IFAA guidelines should not restrict the use of those older books; to do so would infringe the rights of those seeking knowledge from these resources. As the images in such textbooks and atlases are anonymized and are used for teaching and research, and the donors and their families are informed about this before the donation, we believe no additional consent is needed. It is impossible to separate educational from “commercial” usage entirely in any situation, e.g., publications from publishers and the use of cadavers in medical schools. Therefore, our best efforts to avoid unethical use of cadaveric images by following traditional consent processes are still needed so that more people will reap the benefits from them. As senior textbook/atlas authors/editors from over 10 countries, we believe that using cadaveric images in anatomy textbooks is appropriate, and no additional consent should be necessary. Such usage falls within the good faith of professionals using these invaluable gifts.