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Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials

BMJ · 2011 · Vol. 343(jul22 1) · pp. d4002–d4002
Jonathan A C SterneAlex J. SuttonJohn P. A. IoannidisNorma TerrinDavid R. JonesJ. LauJames R. CarpenterGerta RückerRoger HarbordChristopher H. SchmidJennifer TetzlaffJonathan J DeeksJudith PetersPetra MacaskillGuido SchwarzerSue DuvalDouglas G. AltmanDavid MoherJulian P. T. Higgins

Abstract

Funnel plots, and tests for funnel plot asymmetry, have been widely used to examine bias in the results of meta-analyses. Funnel plot asymmetry should not be equated with publication bias, because it has a number of other possible causes. This article describes how to interpret funnel plot asymmetry, recommends appropriate tests, and explains the implications for choice of meta-analysis model

Meta-analysis and systematic reviewsHealth Systems, Economic Evaluations, Quality of LifeMusculoskeletal pain and rehabilitationFunnel plotFunnelAsymmetryPublication biasMeta-analysisPlot (graphics)Forest plotEconometricsStatisticsMathematics

MeSH terms

Statistics as TopicMeta-Analysis as TopicSelection BiasRandomized Controlled Trials as Topic

Funding

  • Cancer Research UK
  • Deutsche Forschungsgemeinschaft
  • Canadian Institutes of Health Research
  • Medical Research Council
Citations
7,148
FWCI
131.07
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46
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