The appropriateness of asymmetry tests for publication bias in meta-analyses: a large survey

The appropriateness of asymmetry tests for publication bias in meta-analyses: a large survey
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DOI:
10.1503/cmaj.060410
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发表时间:
2007-04-10
影响因子:
14.6
通讯作者:
Trikalinos, Thomas A.
Trikalinos, Thomas A.
中科院分区:
医学1区
文献类型:
--
作者:
Ioannidis, John P. A.;Trikalinos, Thomas A.

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背景:漏斗图不对称性的统计检验在荟萃分析中很常见。不适当的应用会产生关于发表偏倚的误导性推论。我们的目的是衡量,在一项调查的荟萃分析,如何频繁地应用这些测试将是没有意义的或inappropriate.Methods:我们评估了所有的荟萃分析的二元结果与>= 3研究的科克伦数据库的系统评价(2003年,第2期)。单独的限制性分析仅限于每篇综述文章中最大的荟萃分析。在每项荟萃分析中,我们评估是否符合应用不对称性检验的标准:无显著异质性,I-2 <50%,>= 10项研究(至少1项研究具有统计学显著性结果),研究间最大与最小方差之比> 4。我们进行了相关性和2回归不对称性测试,并评估其一致性。最后,我们从2005年的印刷期刊中抽取了60篇荟萃分析,引用了标准回归test.Results的使用:6873篇荟萃分析中的366篇(5%)和846篇荟萃分析中的98篇(12%)分别在更广泛和限制性的科克伦数据集中,有资格使用不对称性检验。在7% - 18%的荟萃分析中,不对称检验结果具有显著性。3项检验之间的一致性适中(估计kappa值为0.33 - 0.66)。在60个期刊荟萃分析,7(12%)将有资格进行不对称测试,所有11个索赔识别出版偏见是在面对大的和显着的heterogeneity.Interpretation:统计条件采用不对称测试出版偏见是缺席的大多数荟萃分析,然而,在医学期刊这些测试进行经常和错误的解释。
Background: Statistical tests for funnel-plot asymmetry are common in meta-analyses. Inappropriate application can generate misleading inferences about publication bias. We aimed to measure, in a survey of meta-analyses, how frequently the application of these tests would be not meaningful or inappropriate.Methods: We evaluated all meta-analyses of binary outcomes with >= 3 studies in the Cochrane Database of Systematic Reviews ( 2003, issue 2). A separate, restricted analysis was confined to the largest meta-analysis in each of the review articles. In each meta-analysis, we assessed whether criteria to apply asymmetry tests were met: no significant heterogeneity, I-2 < 50%, >= 10 studies ( with statistically significant results in at least 1) and ratio of the maximal to minimal variance across studies > 4. We performed a correlation and 2 regression asymmetry tests and evaluated their concordance. Finally, we sampled 60 meta-analyses from print journals in 2005 that cited use of the standard regression test.Results: A total of 366 of 6873 (5%) and 98 of 846 meta-analyses (12%) in the wider and restricted Cochrane data set, respectively, would have qualified for use of asymmetry tests. Asymmetry test results were significant in 7% - 18% of the meta-analyses. Concordance between the 3 tests was modest (estimated kappa 0.33 - 0.66). Of the 60 journal meta-analyses, 7 ( 12%) would qualify for asymmetry tests; all 11 claims for identification of publication bias were made in the face of large and significant heterogeneity.Interpretation: Statistical conditions for employing asymmetry tests for publication bias are absent from most meta-analyses; yet, in medical journals these tests are performed often and interpreted erroneously.