Systematic reviews in health care: Investigating and dealing with publication and other biases in meta-analysis - PubMed (original) (raw)

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Systematic reviews in health care: Investigating and dealing with publication and other biases in meta-analysis

J A Sterne et al. BMJ. 2001.

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Figures

Figure 1

Figure 1

Hypothetical funnel plots: left, symmetrical plot in absence of bias (open circles are smaller studies showing no beneficial effects); centre, asymmetrical plot in presence of publication bias (smaller studies showing no beneficial effects are missing); right, asymmetrical plot in presence of bias due to low methodological quality of smaller studies (open circles are small studies of inadequate quality whose results are biased towards larger effects). Solid line is pooled odds ratio and dotted line is null effect (1). Pooled odds ratios exaggerate treatment effects in presence of bias

Figure 2

Figure 2

Regression lines, adjusted for number of measurements of urinary sodium concentration, of predicted change in blood pressure for change in concentration of urinary sodium from randomised controlled trials of reduction in dietary sodium. Intercepts indicate decline in blood pressure even if diets in intervention and control groups were identical, which may indicate presence of bias. Modified from Midgley et al20

Figure 3

Figure 3

Asymmetrical funnel plot of 89 randomised controlled trials comparing homoeopathic medicine with placebo identified by Linde et al25 (top) and application of the “trim and fill” method (bottom). Solid circles represent the 89 trials and open diamonds “filled” studies. Solid line is original (random effects) estimate of pooled odds ratio (0.41), dashed line is adjusted estimate (0.52, including filled studies), and dotted line is null value (1)

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