The DOI matches its Crossref record; 53 of the 54 references it cites were found in a registry or an index.
GRADE guidelines: 5. Rating the quality of evidence—publication bias
Abstract
In the GRADE approach, randomized trials start as high-quality evidence and observational studies as low-quality evidence, but both can be rated down if a body of evidence is associated with a high risk of publication bias. Even when individual studies included in best-evidence summaries have a low risk of bias, publication bias can result in substantial overestimates of effect. Authors should suspect publication bias when available evidence comes from a number of small studies, most of which have been commercially funded. A number of approaches based on examination of the pattern of data are available to help assess publication bias. The most popular of these is the funnel plot; all, however, have substantial limitations. Publication bias is likely frequent, and caution in the face of early results, particularly with small sample size and number of events, is warranted.
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In the citing paper
“Small-sample studies are generally more prone to bias, and the relatively large confidence intervals presented in these studies suggest high uncertainty around the point estimates [47, 48].”
From Depression, anxiety, PTSD, and OCD after stillbirth: a systematic review (2021) · cites this paper as [48]
In the citing paper
“To assess the certainty of the findings’ body of evidence, we will use the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, which evaluates five pillars: risk of bias, imprecision, inconsistency, indirect assessment of outcomes, and publication bias [35].”
From Dialectical Behavior Therapy as an intervention for Treatment Resistant Depression in adults: A protocol for systematic review and meta-analysis (2024) · cites this paper as [35]
In the citing paper
“The overall quality of evidence was graded using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach, considering study limitations, inconsistency, indirectness, imprecision and publication bias [40–44].”
In the citing paper
“Quality of evidence in included systematic reviews was assessed by outcome using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system criteria [17-27].”
From Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews (2015) · cites this paper as [21]
In the citing paper
“To determine the quality of evidence, the GRADE approach was used [29–36].”
In the citing paper
“RCTs are first categorised as high-quality evidence in the GRADE system, while observational studies are classified as low-quality data supporting estimates of intervention effects.”
Citations
Cites
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722
Operating characteristics of a rank correlation test for publication bias
Begg, C. B., & Mazumdar, M. (1994) · Biometrics · doi:10.2307/2533446 · Cited by 16,955
Why Most Published Research Findings Are False
Ioannidis, J. P. A. (2005) · PLoS Medicine · doi:10.1371/journal.pmed.0020124 · Cited by 10,505
Why Most Published Research Findings Are False
Ioannidis, J. P. A. (2005) · CHANCE · doi:10.1080/09332480.2005.10722754 · Cited by 4,702
Publication bias in clinical research
Easterbrook, P. J., Gopalan, R., Berlin, J. A., & Matthews, D. R. (1991) · The Lancet · doi:10.1016/0140-6736(91)90201-y · Cited by 3,109 · cited 1×
“In these instances, reviewers may consider the risk of publication bias as substantial [46,47].”
BackgroundSelective publication of antidepressant trials and its influence on apparent efficacy
Turner, E. H., Matthews, A. M., Linardatos, E., Tell, R. A., & Rosenthal, R. (2008) · New England Journal of Medicine · doi:10.1056/nejmsa065779 · Cited by 2,435
Pharmaceutical industry sponsorship and research outcome and quality: systematic review
Lexchin, J., Bero, L. A., Djulbegovic, B., & Clark, O. (2003) · BMJ · doi:10.1136/bmj.326.7400.1167 · Cited by 2,147 · cited 2×
“The inclination to rate down for publication bias should increase if most of those small studies are industry sponsored or likely to be industry sponsored (or if the investigators share another conflict of interest) [14,23,28].”
BackgroundPeters, J. L., Sutton, A. J., Jones, D. R., Abrams, K. R., & Rushton, L. (2008) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2007.11.010 · Cited by 2,053
The case of the misleading funnel plot
Lau, J., Ioannidis, J. P. A., Terrin, N., Schmid, C. H., & Olkin, I. (2006) · BMJ · doi:10.1136/bmj.333.7568.597 · Cited by 1,766
Empirical assessment of effect of publication bias on meta-analyses
Sutton, A. J. (2000) · BMJ · doi:10.1136/bmj.320.7249.1574 · Cited by 1,398
Research works printed but not linked: 1
- Seagroatt, 1998, Bias in meta-analysis detected by a simple, graphical test. Test had 10% positive rate, BMJ, 316, 470
Cited by
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(2021) · The Journal of Spinal Cord Medicine · doi:10.1080/10790268.2021.1863738 · Cited by 9
Placebo, usual care and wait-list interventions for all mental health disorders
Faltinsen, E., Todorovac, A., Hróbjartsson, A., Gluud, C., Kongerslev, M. T., Simonsen, E., & Storebø, O. J. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.mr000050 · Cited by 9
Junkes, L., Gherman, B. R., Appolinario, J. C., & Nardi, A. E. (2024) · PLoS ONE · doi:10.1371/journal.pone.0303967 · Cited by 4
“To assess the certainty of the findings’ body of evidence, we will use the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, which evaluates five pillars: risk of bias, imprecision, inconsistency, indirect assessment of outcomes, and publication bias [35].”
MethodGiusti, E. M., Spatola, C. A. M., Brunani, A., Kumbhare, D., Oral, A., Ilieva, E., Kiekens, C., Pietrabissa, G., Manzoni, G. M., Imamura, M., et al. (2020) · The Journal of the International Society of Physical and Rehabilitation Medicine · doi:10.4103/jisprm.jisprm_6_20 · Cited by 2
Chiaramonte, R., Ferrillo, M., de Sire, A., & Vecchio, M. (2026) · Journal of Manual & Manipulative Therapy · doi:10.1080/10669817.2026.2629282
Metadata
- Authors
- Guyatt, G. H., Oxman, A. D., Montori, V., Vist, G., Kunz, R., Brozek, J., Alonso-Coello, P., Djulbegovic, B., Atkins, D., Falck-Ytter, Y., Williams, J. W., Meerpohl, J., Norris, S. L., Akl, E. A., & Schünemann, H. J.
- Affiliations
- McMaster University (CA)
- Nasjonalt Kunnskapssenter for Helsetjenesten (NO)
- University Hospital of Basel (CH)
- VA Office of Research and Development (US)
- Case Western Reserve University (US)
- Duke Medical Center (US)
- University Medical Center Freiburg (DE)
- Oregon Health & Science University (US)
- University at Buffalo, State University of New York (US)
- ORCID
- Venue
- Journal of Clinical Epidemiology
- Publisher
- Elsevier BV
- Published
- 2011-12
- Volume
- 64
- Issue
- 12
- Pages
- 1277-1282
- ISSN
- 0895-4356 (ISSN-L)
- OpenAlex
- W2109346853
- Cited by
- 1,819
- References
- 54
- Citations by year
- 2026: 75 · 2025: 142 · 2024: 153 · 2023: 144 · 2022: 172 · 2021: 180 · 2020: 196 · 2019: 120 · 2018: 122 · 2017: 123 · 2016: 109 · 2015: 109 · 2014: 77 · 2013: 51 · 2012: 40
- FWCI
- 57.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Health Sciences › Nursing › Issues, ethics and legal aspects › Pharmaceutical industry and healthcare
- Keywords
- publication bias, GRADE, quality of evidence, funnel plot, small-study effects, commercial funding, risk of bias
- MeSH terms
- Cross-Sectional Studies, Drug Industry, Review Literature as Topic, Statistics as Topic, Meta-Analysis as Topic, Randomized Controlled Trials as Topic, Practice Guidelines as Topic, Publication Bias, Evidence-Based Medicine
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