In an empirical evaluation of the funnel plot, researchers could not visually identify publication bias
In an empirical evaluation of the funnel plot, researchers could not visually identify publication bias
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DOI：
10.1016/j.jclinepi.2005.01.006
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发表时间：
2005-09-01
影响因子：
7.2
通讯作者：
Lau, J
中科院分区：
文献类型：
--
作者：
Terrin, N;Schmid, CH;Lau, J
背景和目的：发表偏见和相关偏见可能导致系统评价得出过于乐观的结论。漏斗图经常用于检测此类偏差，但尚未作为视觉工具进行实证评估。我们试图确定研究人员是否能够通过目视检查典型规模的系统评价中的漏斗图来正确识别发表偏倚。方法：由 41 名医学研究人员完成了一份包含漏斗图的调查问卷，每个研究包含 10 项研究（医学荟萃分析中的中位数），其中包括荟萃分析课程的临床研究员、临床护理研究的教员和经验丰富的系统评价员。结果：平均而言，参与者正确识别了 52.5%（95% CI） 50.6-54.4%）的图受到或未受到发表偏倚的影响。加权平均正确率（根据存在发表偏倚的情况下更可能出现不对称图的事实进行调整）也很低（48.3％至62.8％，取决于是否存在发表偏倚和异质研究效应）。结论：使用漏斗图评估发表偏倚的研究人员可能会被其形状误导。系统评价的作者和读者需要意识到漏斗图的局限性。 (c) 2005 Elsevier Inc. 保留所有权利。
Background and Objective: Publication bias and related biases can lead to overly optimistic conclusions in systematic reviews. The funnel plot, which is frequently used to detect such biases, has not yet been subjected to empirical evaluation as a visual tool. We sought to determine whether researchers can correctly identify publication bias from visual inspection of funnel plots in typical-size systematic reviews.Methods: A questionnaire with funnel plots containing 10 studies each (the median number in medical meta-analyses) was completed by 41 medical researchers, including clinical research fellows in a meta-analysis class, faculty in clinical care research, and experienced systematic reviewers.Results: On average, participants correctly identified 52.5% (95% CI 50.6-54.4%) of the plots as being affected or unaffected by publication bias. The weighted mean percent correct, which adjusted for the fact that asymmetric plots are more likely to occur in the presence of publication bias, was also low (48.3 to 62.8%, depending on the presence or absence of publication bias and heterogeneous study effects).Conclusion: Researchers who assess for publication bias using the funnel plot may be misled by its shape. Authors and readers of systematic reviews need to be aware of the limitations of the funnel plot. (c) 2005 Elsevier Inc. All rights reserved.