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Hedges' G

A standardised effect size measure similar to Cohen's d but corrected for small sample size bias.

Last reviewedDarrin Baines IP Ltd

Concept Architecture

Concept

Theoretically, Hedges' G is a standardised effect size that measures the difference between two group means while correcting for the small-sample bias present in Cohen's d. It is founded on standardised mean difference theory and provides an approximately unbiased estimate of treatment effect magnitude. In health economics, Hedges' G is widely used in meta-analysis, comparative effectiveness research and evidence synthesis when combining continuous outcomes measured on different scales.

Mathematically, Hedges' G is calculated by dividing the difference between group means by the pooled standard deviation and multiplying the result by a correction factor that reduces positive bias in small samples. The correction factor approaches one as sample size increases, making Hedges' G nearly identical to Cohen's d in large studies.

In practice, Hedges' G is estimated using observed group means, standard deviations and sample sizes. It is commonly reported in systematic reviews and meta-analyses to quantify treatment effects across studies using different outcome measures, including health-related quality of life, symptom scores and patient-reported outcomes.


Purpose

Used to quantify standardised differences between treatment groups while correcting for small-sample bias, facilitating comparison and meta-analysis of continuous health outcomes.


Mathematical Formulae

Primary Formula

g = J ? ((x?? ? x??) � s?)

where:

  • g = Hedges' G
  • J = small-sample correction factor
  • x??, x?? = group means
  • s? = pooled standard deviation

Supporting Formulae

Pooled standard deviation:

s? = �[((n? ? 1)s?� + (n? ? 1)s?�) � (n? + n? ? 2)]

Correction factor:

J = 1 ? (3 � (4(n? + n?) ? 9))

where:

  • n?, n? = group sample sizes
  • s?, s? = group standard deviations

Related Mathematical Methods

  • Cohen's D
  • Standardised Mean Difference
  • Meta-Analysis
  • Random-Effects Meta-Analysis
  • Fixed-Effect Meta-Analysis
  • Inverse Variance Weighting

Example

A clinical study reports a mean EQ-5D utility score of 0.82 for the intervention group and 0.74 for the control group. Both groups contain 50 participants and the pooled standard deviation is 0.20.

Cohen's d = (0.82 ? 0.74) � 0.20 = 0.40

J = 1 ? (3 � (4 ? 100 ? 9)) = 0.992

Hedges' G = 0.992 ? 0.40 = 0.397

The intervention therefore demonstrates a small-to-moderate standardised treatment effect.


Excel Implementation

FunctionExample FormulaHealth Economics Application
AVERAGE=AVERAGE(B2:B51)Calculate group mean
STDEV.S=STDEV.S(B2:B51)Calculate group standard deviation
COUNT=COUNT(B2:B51)Determine sample size
SQRT=SQRT(((A2-1)*B2^2+(C2-1)*D2^2)/(A2+C2-2))Calculate pooled standard deviation

VBA (Optional)

Automate calculation of Hedges' G across multiple studies and generate effect size tables for systematic reviews and meta-analyses.


Sources

  • Hedges LV. Distribution Theory for Glass's Estimator of Effect Size and Related Estimators. Journal of Educational Statistics. 1981.
  • Hedges LV, Olkin I. Statistical Methods for Meta-Analysis.
  • Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to Meta-Analysis.
  • Cochrane Handbook for Systematic Reviews of Interventions.
  • Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions.

Library

Publications

1
  • Book

    Bayesian Methods in Health Economics — Gianluca Baio, 1st Edition ed., 2012 (Chapman & Hall / CRC Press)

    An overview of Bayesian statistical methods for the analysis of health economic data, covering economic evaluation concepts, statistical cost-effectiveness analysis, Bayesian computation and MCMC, and applied health economic evaluation.

Frequently Asked Questions (6)

  • What is Hedges' g?

    A standardised effect size measure similar to Cohen's d but corrected for small sample size bias.

    Source: Hedges 1981

  • Why does Hedges' g adjust Cohen's d for small samples?

    Hedges' g is a standardised effect size much like Cohen's d, expressing the difference between two group means in units of their pooled standard deviation, but with a correction applied for small samples. That correction matters because Cohen's d tends to overstate the true effect when samples are small, and Hedges' g scales it down to remove this upward bias. This makes it the safer choice for small studies and for meta-analyses combining them. Correcting the small-sample bias in a standardised difference is its purpose. Borenstein and colleagues (2009) describe this measure.

    Source: Borenstein et al. 2009

  • How is Hedges' g calculated?

    Hedges' g is calculated much like Cohen's d, as the difference between the two group means divided by a pooled standard deviation, but then multiplied by a correction factor that depends on the sample size and reduces the small-sample bias, bringing the estimate closer to the true effect. So Hedges' g is calculated by taking the standardised mean difference and applying a correction that shrinks it slightly, with the correction being larger for smaller samples and negligible for large ones, which yields a standardised effect size that is approximately unbiased and thus more suitable than the uncorrected Cohen's d when sample sizes are small.

    Source: Hedges 1981

  • How does Hedges' g differ from Cohen's d?

    Hedges' g differs from Cohen's d in applying a correction for small-sample bias: Cohen's d, the standardised mean difference, tends to overestimate the effect in small samples, and Hedges' g multiplies it by a factor that removes most of this bias. In large samples the two are nearly identical. So Hedges' g and Cohen's d are closely related standardised mean differences, differing chiefly in the small-sample correction, with Hedges' g preferred when samples are small because it is approximately unbiased, while the two converge as the sample size grows, so the distinction matters most for small studies.

    Source: Hedges 1981

  • When is Hedges' g preferred?

    Hedges' g is preferred when sample sizes are small, since Cohen's d overestimates the effect in small samples and Hedges' g corrects for this bias, and it is commonly used in meta-analysis, where combining studies of varying, sometimes small, sizes makes the correction valuable. So Hedges' g is preferred for small studies and for meta-analytic synthesis, because its bias correction gives a more accurate standardised effect size when samples are limited, which is why it is often the default standardised mean difference in meta-analysis, ensuring that effect sizes from small studies are not systematically overstated.

    Source: Hedges 1981

  • Why is the small-sample correction important in Hedges' g?

    The small-sample correction in Hedges' g is important because the uncorrected standardised mean difference is biased upward when samples are small, so without correction effect sizes from small studies would be systematically overstated, distorting their interpretation and their contribution to a meta-analysis. So the small-sample correction matters for accuracy, since it removes most of the upward bias, giving a more truthful estimate of the effect size in small studies and preventing the overestimation that would otherwise occur, which is particularly important when synthesising evidence across studies of different sizes, where uncorrected estimates could bias the combined result.

    Source: Hedges 1981

Trust Record

Verified by Dr Darrin Baines

British health economist

Professional identity: darrinbaines.org

Verification date: 16 Dec 2025

Content version: 1.0.0

Canonical Identity

Term code
HE-ES-SA-076

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