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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“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
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“In these instances, reviewers may consider the risk of publication bias as substantial [46,47].”
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- Seagroatt, 1998, Bias in meta-analysis detected by a simple, graphical test. Test had 10% positive rate, BMJ, 316, 470
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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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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