OBJECTIVE: The aim of this study was to examine the presence and extent of small study effects and publication bias in meta-analyses (MAs) based on orthodontic studies. MATERIALS AND METHODS: Following an extensive literature search, 25 MAs including 313 studies were identified and were possible to be re-analyzed. For the assessment of publication bias, contour-enhanced funnel plots were examined and their symmetry was tested using the Begg and Mazumdar rank correlation and Egger's linear regression tests. Robustness of MAs' results to publication bias was examined by Rosenthal's failsafe N, and adjusted effect sizes were calculated after consideration of publication bias using Duval and Tweedie's "trim and fill" procedure. RESULTS: Only few of the originally published MAs assessed the existence and effect of publication bias and some only partially. Inspection of the funnel plots indicated possible asymmetry, which was confirmed by Begg and Mazumdar's test in 12 % and by Egger's test in 28 % of the MAs. According to Rosenthal's criterion, 62 % of the MAs were robust, while adjusted effect estimates with unpublished studies differed from little to great from the unadjusted ones. Pooling of Egger's intercepts of included MAs indicated that evidence of asymmetry was found in the orthodontic literature, which was accentuated in medical journals and in diagnostic MAs. CONCLUSIONS: Small study effects and publication bias can often distort results of MAs. Since indications of publication bias in orthodontics were found, the influence of small trials on estimated treatment effects should be routinely and more carefully assessed by authors conducting MAs.
OBJECTIVE: The aim of this study was to examine the presence and extent of small study effects and publication bias in meta-analyses (MAs) based on orthodontic studies. MATERIALS AND METHODS: Following an extensive literature search, 25 MAs including 313 studies were identified and were possible to be re-analyzed. For the assessment of publication bias, contour-enhanced funnel plots were examined and their symmetry was tested using the Begg and Mazumdar rank correlation and Egger's linear regression tests. Robustness of MAs' results to publication bias was examined by Rosenthal's failsafe N, and adjusted effect sizes were calculated after consideration of publication bias using Duval and Tweedie's "trim and fill" procedure. RESULTS: Only few of the originally published MAs assessed the existence and effect of publication bias and some only partially. Inspection of the funnel plots indicated possible asymmetry, which was confirmed by Begg and Mazumdar's test in 12 % and by Egger's test in 28 % of the MAs. According to Rosenthal's criterion, 62 % of the MAs were robust, while adjusted effect estimates with unpublished studies differed from little to great from the unadjusted ones. Pooling of Egger's intercepts of included MAs indicated that evidence of asymmetry was found in the orthodontic literature, which was accentuated in medical journals and in diagnostic MAs. CONCLUSIONS: Small study effects and publication bias can often distort results of MAs. Since indications of publication bias in orthodontics were found, the influence of small trials on estimated treatment effects should be routinely and more carefully assessed by authors conducting MAs.
Authors: Paulo Frazão; Paulo Capel Narvai; Maria do Rosário Dias de Oliveira Latorre; Roberto Augusto Castellanos Journal: Rev Saude Publica Date: 2004-04-26 Impact factor: 2.106
Authors: Jonathan A C Sterne; Alex J Sutton; John P A Ioannidis; Norma Terrin; David R Jones; Joseph Lau; James Carpenter; Gerta Rücker; Roger M Harbord; Christopher H Schmid; Jennifer Tetzlaff; Jonathan J Deeks; Jaime Peters; Petra Macaskill; Guido Schwarzer; Sue Duval; Douglas G Altman; David Moher; Julian P T Higgins Journal: BMJ Date: 2011-07-22