highly significantP <10 -4
With the exclusion of the initial positive report, which tends to suggest a stronger genetic effect (winner's curse) than those in subsequent studies [ 9 - 11 , 16 ], the cumulative OR decreased slightly but remained highly significant ( P <10 -4 ) with no significant heterogeneity ( P heterogeneity = 0.47, I 2 = 0%) (see Figure 3 caption).