Small studies may overestimate the effect sizes in critical care meta-analyses: a meta-epidemiological study
Open accessAbstract
INTRODUCTION: Small-study effects refer to the fact that trials with limited sample sizes are more likely to report larger beneficial effects than large trials. However, this has never been investigated in critical care medicine. Thus, the present study aimed to examine the presence and extent of small-study effects in critical care medicine. METHODS: Critical care meta-analyses involving randomized controlled trials and reported mortality as an outcome measure were considered eligible for the study. Component trials were classified as large (≥100 patients per arm) and small (<100 patients per arm) according to their sample sizes. Ratio of odds ratio (ROR) was calculated for each meta-analysis and then RORs were combined using a meta-analytic approach. ROR<1 indicated larger beneficial effect in small trials. Small and large trials were compared in methodological qualities including sequence generating, blinding, allocation concealment, intention to treat and sample size calculation. RESULTS: A total of 27 critical care meta-analyses involving 317 trials were included. Of them, five meta-analyses showed statistically significant RORs <1, and other meta-analyses did not reach a statistical significance. Overall, the pooled ROR was 0.60 (95% CI: 0.53 to 0.68); the heterogeneity was moderate with an I2 of 50.3% (chi-squared = 52.30; P = 0.002). Large trials showed significantly better reporting quality than small trials in terms of sequence generating, allocation concealment, blinding, intention to treat, sample size calculation and incomplete follow-up data. CONCLUSIONS: Small trials are more likely to report larger beneficial effects than large trials in critical care medicine, which could be partly explained by the lower methodological quality in small trials. Caution should be practiced in the interpretation of meta-analyses involving small trials.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Smaller studies can sometimes overestimate effect sizes even when no true effect is present.
“It is possible that these findings were driven by the fact that smaller studies can sometimes overestimate effect sizes even when no true effect is present (Walum et al., 2016;Zhang et al., 2013).”
From Meta-analytic review of the effects of a single dose of intranasal oxytocin on threat processing in humans (2018) · cites this paper as Zhang et al., 2013
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
1 retracted
Reilly, C. (2011) · British Journal of Anaesthesia · doi:10.1093/bja/aer068 · Cited by 27 · see citing works
RetractedCONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials
the CONSORT Group, Schulz, K. F., Altman, D. G., & Moher, D. (2010) · BMC Medicine · doi:10.1186/1741-7015-8-18 · Cited by 13,371 · see citing works
CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials
Schulz, K. F., Altman, D. G., Moher, D., & for the CONSORT Group (2010) · BMJ · doi:10.1136/bmj.c332 · Cited by 9,329 · see citing works
Funnel plots for detecting bias in meta-analysis
Sterne, J. A. C., & Egger, M. (2001) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(01)00377-8 · Cited by 3,779 · see citing works
Moher, D., Pham, B., Jones, A., Cook, D. J., Jadad, A. R., Moher, M., Tugwell, P., & Klassen, T. P. (1998) · The Lancet · doi:10.1016/s0140-6736(98)01085-x · Cited by 3,560 · see citing works
Wood, L., Egger, M., Gluud, L. L., Schulz, K. F., Jüni, P., Altman, D. G., Gluud, C., Martin, R. M., Wood, A. J. G., & Sterne, J. A. C. (2008) · BMJ · doi:10.1136/bmj.39465.451748.ad · Cited by 2,538 · see citing works
Gluud, L. L., Villumsen, J., & Gluud, C. N. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-135-11-200112040-00010 · Cited by 2,262 · see citing works
Egger, M., Jüni, P., Bartlett, C., Holenstein, F., & Sterne, J. (2003) · Health Technology Assessment · doi:10.3310/hta7010 · Cited by 1,181 · cited 1× · see citing works
“However, this is an unsettled question and there are other studies supporting our finding [38,39].”
ResultImpact of the Pulmonary Artery Catheter in Critically Ill Patients
Shah, M. R., Hasselblad, V., Stevenson, L. W., Binanay, C. A., O’Connor, C. M., Sopko, G. S., & Califf, R. M. (2005) · JAMA · doi:10.1001/jama.294.13.1664 · Cited by 786 · see citing works
Chan, A.-W., & Altman, D. G. (2005) · BMJ · doi:10.1136/bmj.38356.424606.8f · Cited by 613 · cited 1× · see citing works
“This effect can be explained, at least partly, by the combination of lower methodological quality of small studies and publication bias [2,3].”
BackgroundSmall study effects in meta-analyses of osteoarthritis trials: meta-epidemiological study
Nuesch, E., Trelle, S., Reichenbach, S., Rutjes, A. W. S., Tschannen, B., Altman, D. G., Egger, M., & Juni, P. (2010) · BMJ · doi:10.1136/bmj.c3515 · Cited by 559 · see citing works
Corticosteroids in the Treatment of Severe Sepsis and Septic Shock in Adults
Annane, D., Bellissant, É., Bollaert, P., Briegel, J., Confalonieri, M., Gaudio, R. D., Keh, D., Kupfer, Y. Y., Oppert, M., & Meduri, G. U. (2009) · JAMA · doi:10.1001/jama.2009.815 · Cited by 557 · see citing works
Balk, E. M. (2002) · JAMA · doi:10.1001/jama.287.22.2973 · Cited by 478 · see citing works
Sterne, J. A. C., Jüni, P., Schulz, K. F., Altman, D. G., Bartlett, C., & Egger, M. (2002) · Statistics in Medicine · doi:10.1002/sim.1184 · Cited by 382 · see citing works
Delaney, A. P., Dan, A., McCaffrey, J., & Finfer, S. R. (2011) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181ffe217 · Cited by 344 · see citing works
Blackwood, B., Alderdice, F. A., Burns, K. E. A., Cardwell, C. R., Lavery, G., & O’Halloran, P. D. (2011) · BMJ · doi:10.1136/bmj.c7237 · Cited by 333 · see citing works
Immunonutrition in critically ill patients: a systematic review and analysis of the literature
Marik, P. E., & Zaloga, G. P. (2008) · Intensive Care Medicine · doi:10.1007/s00134-008-1213-6 · Cited by 295 · see citing works
Tan, J. A., & Ho, K. M. (2010) · Intensive Care Medicine · doi:10.1007/s00134-010-1877-6 · Cited by 282 · see citing works
Kopterides, P., Siempos, I. Ι., Tsangaris, I., Tsantes, A. Ε., & Armaganidis, A. (2010) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181f17bf9 · Cited by 243 · see citing works
Laupland, K. B., Kirkpatrick, A. W., & Delaney, A. P. (2007) · Critical Care Medicine · doi:10.1097/01.ccm.0000295312.13466.1c · Cited by 233 · see citing works
Siempos, I. I., Ntaidou, T. K., & Falagas, M. E. (2010) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181c8fe4b · Cited by 204 · see citing works
Barkun, A. N., Bardou, M., Pham, C. Q. D., & Martel, M. (2012) · The American Journal of Gastroenterology · doi:10.1038/ajg.2011.474 · Cited by 162 · see citing works
The Timing of Tracheotomy in Critically Ill Patients Undergoing Mechanical Ventilation
Wang, F., Wu, Y., Bo, L., Lou, J., Zhu, J., Chen, F., Li, J., & Deng, X. (2011) · CHEST Journal · doi:10.1378/chest.11-2024 · Cited by 149 · see citing works
Abroug, F., Ouanes-Besbes, L., Dachraoui, F., Ouanes, I., & Brochard, L. J. (2011) · Critical Care · doi:10.1186/cc9403 · Cited by 141 · see citing works
Afshari, A., Brok, J. S., Møller, A. M., & Wetterslev, J. (2011) · Anesthesia & Analgesia · doi:10.1213/ane.0b013e31820bd185 · Cited by 140 · see citing works
Neto, A. S., Nassar, A. P., Cardoso, S. O., Manetta, J. A., Pereira, V. G., Espósito, D. C., Damasceno, M. C. T., & Russell, J. A. (2012) · Critical Care · doi:10.1186/cc11469 · Cited by 127 · see citing works
Norepinephrine or Dopamine for Septic Shock
Vasu, T. S., Cavallazzi, R., Hirani, A., Kaplan, G., Leiby, B. E., & Marik, P. E. (2011) · Journal of Intensive Care Medicine · doi:10.1177/0885066610396312 · Cited by 108 · see citing works
Pileggi, C., Bianco, A., Flotta, D., Nobile, C. G. A., & Pavía, M. (2011) · Critical Care · doi:10.1186/cc10285 · Cited by 105 · see citing works
Phoenix, S. I., Paravastu, S. C. V., Columb, M. O., Vincent, J., & Nirmalan, M. (2009) · Anesthesiology · doi:10.1097/aln.0b013e31819fae06 · Cited by 101 · see citing works
Burns, K. E. A., Adhikari, N. K. J., Slutsky, A. S., Guyatt, G. H., Villar, J., Zhang, H., Zhou, Q. X., Cook, D. J., Stewart, T. E., & Meade, M. O. (2011) · PLoS ONE · doi:10.1371/journal.pone.0014623 · Cited by 99 · see citing works
Afshari, A., Wetterslev, J., Brok, J. S., & Møller, A. M. (2007) · BMJ · doi:10.1136/bmj.39398.682500.25 · Cited by 94 · see citing works
Siersma, V., Als-Nielsen, B. E. T., Chen, W., Hilden, J., Gluud, L. L., & Gluud, C. N. (2006) · Statistics in Medicine · doi:10.1002/sim.2752 · Cited by 84 · see citing works
Subglottic secretion drainage for preventing ventilator-associated pneumonia
Wang, F., Bo, L., Tang, L., Lou, J., Wu, Y., Chen, F., Li, J., & Deng, X. (2012) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0b013e318247cd33 · Cited by 72 · see citing works
Augustes, R., & Ho, K. M. (2011) · Anaesthesia and Intensive Care · doi:10.1177/0310057x1103900310 · Cited by 65 · see citing works
Landoni, G., Mizzi, A., Biondi‐Zoccai, G., Bignami, E. G., Prati, P. L., Ajello, V., Marino, G., Guarracino, F., & Zangrillo, A. (2010) · PubMed · Cited by 59 · see citing works
Micronutrient supplementation for critically ill adults: A systematic review and meta-analysis
Visser, J., Labadarios, D., & Blaauw, R. (2011) · Nutrition · doi:10.1016/j.nut.2010.12.009 · Cited by 52 · see citing works
Zarychanski, R., Turgeon, A. F., Fergusson, D. A., Cook, D. J., Hébert, P. C., Bagshaw, S. M., Monsour, D. A., & McIntyre, L. (2009) · PubMed Central · Cited by 47 · see citing works
Puskarich, M. A., Runyon, M. S., Trzeciak, S., Kline, J. A., & Jones, A. E. (2009) · The Journal of Clinical Pharmacology · doi:10.1177/0091270009334375 · Cited by 23 · see citing works
Zhang, Z., Xu, X., & Hongyang, Z. (2010) · Journal of Critical Care · doi:10.1016/j.jcrc.2010.05.030 · Cited by 21 · see citing works
Zarychanski, R., Turgeon, A. F., Fergusson, D. A., Cook, D. J., Hébert, P. C., Bagshaw, S. M., Monsour, D. A., & McIntyre, L. (2009) · PubMed Central · Cited by 18 · see citing works
Shan, L., Hao, P., & Chen, Y. (2011) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0b013e3182250515 · Cited by 13 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Goal-Directed Resuscitation for Patients with Early Septic Shock
The ARISE Investigators and the ANZICS Clinical Trials Group (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1404380 · Cited by 2,023 · see citing works
Guidelines for reporting meta-epidemiological methodology research
Murad, M. H., & Wang, Z. (2017) · Evidence Based Medicine · doi:10.1136/ebmed-2017-110713 · Cited by 515 · see citing works
Ludyga, S., Gerber, M., Pühse, U., Looser, V. N., & Kamijo, K. (2020) · Nature Human Behaviour · doi:10.1038/s41562-020-0851-8 · Cited by 481 · see citing works
Effectiveness, Core Elements, and Moderators of Response of Cognitive Remediation for Schizophrenia
Vita, A., Barlati, S., Ceraso, A., Nibbio, G., Ariu, C., Deste, G., & Wykes, T. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2021.0620 · Cited by 469 · see citing works
Risk factors for child sexual abuse victimization: A meta-analytic review.
Assink, M., van der Put, C. E., Meeuwsen, M. W. C. M., de Jong, N. M., Oort, F. J., Stams, G. J. J. M., & Hoeve, M. (2019) · Psychological bulletin · doi:10.1037/bul0000188 · Cited by 322 · see citing works
Hendriks, T., Schotanus-Dijkstra, M., Hassankhan, A., de Jong, J. T. V. M., & Bohlmeijer, E. T. (2019) · Journal of Happiness Studies · doi:10.1007/s10902-019-00082-1 · Cited by 332 · see citing works
Intensive glucose control versus conventional glucose control for type 1 diabetes mellitus
Fullerton, B., Jeitler, K., Seitz, M., Horvath, K., Berghold, A., & Siebenhofer, A. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009122.pub2 · Cited by 299 · see citing works
Patel, A., Laffan, M., Waheed, U., & Brett, S. J. (2014) · BMJ · doi:10.1136/bmj.g4561 · Cited by 289 · see citing works
Lying takes time: A meta-analysis on reaction time measures of deception.
Suchotzki, K., Verschuère, B., Bockstaele, B. V., Ben‐Shakhar, G., & Crombez, G. (2017) · Psychological Bulletin · doi:10.1037/bul0000087 · Cited by 288 · see citing works
Chaboyer, W. P., Thalib, L., Harbeck, E., Coyer, F. M., Blot, S. I., Bull, C. F., Nogueira, P. C., & Lin, F. F. (2018) · Critical Care Medicine · doi:10.1097/ccm.0000000000003366 · Cited by 276 · see citing works
Duan, X., Coburn, M., Rossaint, R., Sanders, R. D., Waesberghe, J. V., & Kowark, A. (2018) · British Journal of Anaesthesia · doi:10.1016/j.bja.2018.04.046 · Cited by 246 · see citing works
Zhang, Z., Xu, X., Ye, S., & Xu, L. (2014) · Ultrasound in Medicine & Biology · doi:10.1016/j.ultrasmedbio.2013.12.010 · Cited by 244 · see citing works
Nascimento, G. G., Leite, F. R. M., Vestergaard, P., Scheutz, F., & López, R. (2018) · Acta Diabetologica · doi:10.1007/s00592-018-1120-4 · Cited by 235 · see citing works
Salzwedel, C., Puig, J., Carstens, A., Bein, B., Molnár, Z., Kiss, K., Hussain, A., Belda, J., Кirov, М. Y., Sakka, S. G., et al. (2013) · Critical Care · doi:10.1186/cc12885 · Cited by 225 · see citing works
Publication bias in meta‐analyses from the Cochrane Database of Systematic Reviews
Kiciński, M., Springate, D. A., & Kontopantelis, E. (2015) · Statistics in Medicine · doi:10.1002/sim.6525 · Cited by 213 · see citing works
Recurrence of FSGS after Kidney Transplantation in Adults
Uffing, A., Pérez‐Sáez, M. J., Mazzali, M., Manfro, R. C., Bauer, A. C., Drumond, F. D. S., O'Shaughnessy, M. M., Cheng, X. S., Chin, K., Ventura, C. G., et al. (2020) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.08970719 · Cited by 202 · see citing works
Tayfur, B., Charuphongsa, C., Morrissey, D., & Miller, S. (2020) · Sports Medicine · doi:10.1007/s40279-020-01386-6 · Cited by 190 · see citing works
Cheng, J., Pullenayegum, E., Marshall, J. K., Iorio, A., & Thabane, L. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-010983 · Cited by 163 · see citing works
Stress ulcer prophylaxis versus placebo or no prophylaxis in critically ill patients
Krag, M., Perner, A., Wetterslev, J., Wise, M. P., & Møller, M. H. (2013) · Intensive Care Medicine · doi:10.1007/s00134-013-3125-3 · Cited by 148 · see citing works
Elke, G., Hartl, W. H., Kreymann, K. G., Adolph, M., Felbinger, T. W., Graf, T., de Heer, G., Heller, A. R., Kampa, U., Mayer, K., et al. (2019) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2019.05.002 · Cited by 150 · see citing works
Nasogastric or nasojejunal feeding in predicted severe acute pancreatitis: a meta-analysis
Chang, Y.-S., Fu, H.-Q., Xiao, Y., & Liu, J. (2013) · Critical Care · doi:10.1186/cc12790 · Cited by 144 · see citing works
Peake, S., Bailey, M., Bellomo, R., Cooper, D. J., Higgins, A. M., & Howe, B. D. (2014) · Cited by 142 · see citing works
Nielsen, O. H., Gubatan, J. M. B., Juhl, C. B., Streett, S. E., & Maxwell, C. V. (2020) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2020.09.021 · Cited by 144 · see citing works
Gargiulo, G., Giacoppo, D., Jolly, S. S., Cairns, J. A., May, M. R. L., Bernát, I., Romagnoli, E., Rao, S. V., van Leeuwen, M. A. H., Mehta, S. R., et al. (2022) · Circulation · doi:10.1161/circulationaha.122.061527 · Cited by 136 · see citing works
Interventions to prevent and manage overweight or obesity in preschool children: A systematic review
Ling, J., Robbins, L. B., & Wen, F. (2015) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2015.10.017 · Cited by 130 · see citing works
Caldeira, D., Rodrigues, F. B., Barra, M., Santos, A. T., Abreu, D., Gonçalves, N., Pinto, F. J., Ferreira, J. J., & Costa, J. N. (2015) · Heart · doi:10.1136/heartjnl-2015-307489 · Cited by 123 · see citing works
Ninet, S., Schnell, D., Dewitte, A., Zéni, F., Meziani, F., & Darmon, M. (2015) · Journal of Critical Care · doi:10.1016/j.jcrc.2015.02.008 · Cited by 123 · see citing works
Synthesizing Evidence from Diagnostic Accuracy TEsts : the SEDATE guideline
Sotiriadis, A., Papatheodorou, S., & Martins, W. P. (2015) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.15762 · Cited by 119 · see citing works
Qian, Z., Yang, M., Li, L., & Chen, Y. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-021189 · Cited by 108 · see citing works
Gjuladin-Hellon, T., Davies, I. G., Penson, P., & Amiri Baghbadorani, R. (2019) · Nutrition Reviews · doi:10.1093/nutrit/nuy049 · Cited by 108 · see citing works
Caldeira, D., Barra, M., Santos, A. T., Abreu, D., Pinto, F. J., Ferreira, J. J., & Costa, J. N. (2014) · Heart · doi:10.1136/heartjnl-2013-305288 · Cited by 105 · see citing works
Ferreira, G. E., Shaheed, C. A., Underwood, M. R., Finnerup, N. B., Day, R. O., McLachlan, A. J., Eldabe, S. S., Zadro, J. R., & Maher, C. G. (2023) · BMJ · doi:10.1136/bmj-2022-072415 · Cited by 106 · see citing works
Intracranial hemorrhage risk with the new oral anticoagulants: a systematic review and meta-analysis
Caldeira, D., Barra, M., Pinto, F. J., Ferreira, J. J., & Costa, J. N. (2014) · Journal of Neurology · doi:10.1007/s00415-014-7462-0 · Cited by 99 · see citing works
Publication Bias in Recent Meta-Analyses
Kiciński, M. (2013) · PLoS ONE · doi:10.1371/journal.pone.0081823 · Cited by 95 · see citing works
Leppänen, J., Sedgewick, F., Treasure, J. L., & Tchanturia, K. (2018) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2018.04.009 · Cited by 93 · see citing works
Schnaubelt, S., Garg, R. K., Atiq, H., Baig, N., Bernardino, M., Bigham, B. L., Dickson, S., Geduld, H. I., Al-Hilali, Z., Karki, S., et al. (2023) · The Lancet Global Health · doi:10.1016/s2214-109x(23)00302-9 · Cited by 90 · see citing works
Akbar, M. R., Wibowo, A., Pranata, R., & Setiabudiawan, B. (2021) · Frontiers in Nutrition · doi:10.3389/fnut.2021.660420 · Cited by 87 · see citing works
Alhazzani, W. A., Almasoud, A., Jaeschke, R., Lo, B., Sindi, A., Altayyar, S., & Fox‐Robichaud, A. (2013) · Critical Care · doi:10.1186/cc12806 · Cited by 87 · see citing works
Comorbidities in Patients with Vitiligo: A Systematic Review and Meta-Analysis
Lee, J. H., Ju, H. J., Seo, J. M., Almurayshid, A., Kim, G. M., Ezzedine, K., & Bae, J. M. (2022) · Journal of Investigative Dermatology · doi:10.1016/j.jid.2022.10.021 · Cited by 86 · see citing works
Empirical evaluation of which trial characteristics are associated with treatment effect estimates
Dechartres, A., Trinquart, L., Faber, T., & Ravaud, P. (2016) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2016.04.005 · Cited by 85 · see citing works
Chaimani, A., Vasiliadis, H. S., Pandis, N., Schmid, C. H., Welton, N. J., & Salanti, G. (2013) · International Journal of Epidemiology · doi:10.1093/ije/dyt074 · Cited by 82 · see citing works
Drug therapy for delirium in terminally ill adults
Finucane, A., Jones, L., Leurent, B., Sampson, E. L., Stone, P. C., Tookman, A. J., & Candy, B. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004770.pub3 · Cited by 82 · see citing works
Interventions for sexual dysfunction following treatments for cancer in women
Candy, B., Chi, Y., Graham‐Wisener, L., Jones, L., King, M., Lanceley, A., Vickerstaff, V., & Tookman, A. J. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005540.pub3 · Cited by 84 · see citing works
de Mooij, B., Fekkes, M., Scholte, R. H. J., & Overbeek, G. J. (2020) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-019-00308-x · Cited by 87 · see citing works
DGEM-Leitlinie: „Klinische Ernährung in der Intensivmedizin“
Elke, G., Hartl, W. H., Kreymann, K. G., Adolph, M., Felbinger, T. W., Graf, T., de Heer, G., Heller, A. R., Kampa, U., Mayer, K., et al. (2018) · Aktuelle Ernährungsmedizin · doi:10.1055/a-0713-8179 · Cited by 76 · see citing works
Do negative symptoms of schizophrenia change over time? A meta-analysis of longitudinal data
Savill, M., Banks, C., Khanom, H., & Priebe, S. (2014) · Psychological Medicine · doi:10.1017/s0033291714002712 · Cited by 72 · see citing works
Liu, Y., Yang, Y., Zhao, J., Chen, X., Wang, J., Ma, Y., Huang, B., Yuan, D., & Du, X. (2019) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2019.06.105 · Cited by 68 · see citing works
Kicinski, M. (2014) · BMJ Open · doi:10.1136/bmjopen-2014-004831 · Cited by 61 · see citing works
Ammann, E. M., Haskins, C., Fillman, K. M., Ritter, R. L., Gu, X., Winiecki, S. K., Carnahan, R. M., Torner, J. C., FIREMAN, B. H., Jones, M. P., et al. (2016) · American Journal of Hematology · doi:10.1002/ajh.24358 · Cited by 66 · see citing works
Different research designs and their characteristics in intensive care
Nedel, W. L., & da Silveira, F. (2016) · Revista Brasileira de Terapia Intensiva · doi:10.5935/0103-507x.20160050 · Cited by 65 · see citing works
Caldeira, D., Barra, M., Ferreira, A., Rocha, A., Augusto, A., Pinto, F. J., Costa, J. N., & Ferreira, J. J. (2015) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.13412 · Cited by 66 · see citing works
Conde‐Agudelo, A., & Romero, R. J. (2022) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.04.023 · Cited by 65 · see citing works
Evidence-based occupational health and safety interventions: a comprehensive overview of reviews
Teufer, B., Ebenberger, A., Affengruber, L., Kien, C., Klerings, I., Szeląg, M., Grillich, L., & Griebler, U. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-032528 · Cited by 62 · see citing works
Perioperative statin therapy in cardiac surgery: a meta-analysis of randomized controlled trials
Putzu, A., Capelli, B., Belletti, A., Cassina, T., Ferrari, E., Gallo, M., Casso, G., & Landoni, G. (2016) · Critical Care · doi:10.1186/s13054-016-1560-6 · Cited by 60 · see citing works
Video Laryngoscopy for Endotracheal Intubation of Critically Ill Adults
Huang, H., Peng, J., Xu, B., Liu, G.-Y., & Du, B. (2017) · CHEST Journal · doi:10.1016/j.chest.2017.06.012 · Cited by 61 · see citing works
Zhang, Q., Wang, F., Geng, Q., Zheng, W., Ng, C. H., Ungvari, G. S., Yuan, Z., Mei, S., Wang, G., & Xiang, Y. (2018) · International Journal of Biological Sciences · doi:10.7150/ijbs.25001 · Cited by 63 · see citing works
Wang, R., Yan, W., Du, M., Tao, L., & Liu, J. (2021) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2021.02.095 · Cited by 61 · see citing works
Sedation of mechanically ventilated adults in intensive care unit: a network meta-analysis
Zhang, Z., Chen, K., Ni, H., Zhang, X., & Fan, H. (2017) · Scientific Reports · doi:10.1038/srep44979 · Cited by 60 · see citing works
Caldeira, D., Nunes-Ferreira, A., Rodrigues, R. O., Vicente, E., Pinto, F. J., & Ferreira, J. J. (2018) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2018.12.013 · Cited by 60 · see citing works
Meta-analysis for orthodontists: Part II – Is all that glitters gold?
Papageorgiou, S. N. (2014) · Journal of Orthodontics · doi:10.1179/1465313314y.0000000110 · Cited by 58 · see citing works
Positive affect and chronic pain: a preregistered systematic review and meta-analysis
Ong, A. D., Thoemmes, F. J., Ratner, K., Ghezzi‐Kopel, K., & Reid, M. C. (2020) · Pain · doi:10.1097/j.pain.0000000000001828 · Cited by 56 · see citing works
Neuromuscular joint function in knee osteoarthritis: A systematic review and meta-analysis
Tayfur, B., Charuphongsa, C., Morrissey, D., & Miller, S. (2022) · Annals of Physical and Rehabilitation Medicine · doi:10.1016/j.rehab.2022.101662 · Cited by 56 · see citing works
Clinical outcomes from out-of-hospital cardiac arrest in low-resource settings — A scoping review
Schnaubelt, S., Monsieurs, K. G., Semeraro, F. F., Schlieber, J., Cheng, A., Bigham, B. L., Garg, R. K., Finn, J., Greif, R. T., Bray, J., et al. (2020) · Resuscitation · doi:10.1016/j.resuscitation.2020.08.126 · Cited by 57 · see citing works
Baumeister, H., Paganini, S., Sander, L. B., Lin, J., Schlicker, S., Terhorst, Y., Moshagen, M., Bengel, J., Lehr, D., & Ebert, D. D. (2021) · Psychotherapy and Psychosomatics · doi:10.1159/000511881 · Cited by 55 · see citing works
Tong, E., Chen, Y., Ren, Y., Zhou, Y., Di, C., Zhou, Y., Shao, S., Qiu, S., Hong, Y., Yang, L., et al. (2022) · Frontiers in Nutrition · doi:10.3389/fnut.2022.951676 · Cited by 57 · see citing works
Groff, M. L., Offringa, M., Emdin, A. L., Mahood, Q., Parkin, P. C., & Cohen, E. (2020) · Children · doi:10.3390/children7120293 · Cited by 53 · see citing works
Papageorgiou, S. N., Antonoglou, G. N., Tsiranidou, E., Jepsen, S. V., & Jäger, A. (2014) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2014.04.002 · Cited by 52 · see citing works
Salah, H. M., Savarese, G., Rosano, G. M. C., Ambrosy, A. P., Mentz, R. J., & Fudim, M. (2023) · ESC Heart Failure · doi:10.1002/ehf2.14310 · Cited by 51 · see citing works
Candy, B., Jones, L., Vickerstaff, V., Larkin, P. J., & Stone, P. C. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006332.pub3 · Cited by 51 · see citing works
Salimi, Y., Taghdir, M., Sepandi, M., & Zarchi, A. A. K. (2019) · BMC Public Health · doi:10.1186/s12889-019-6484-z · Cited by 50 · see citing works
Intubation rate of patients with hypoxia due to COVID-19 treated with awake proning: A meta-analysis
Cardona, S., Downing, J. V., Alfalasi, R. B., Bzhilyanskaya, V., MILZMAN, D. P., Rehan, M., Schwartz, B., Yardi, I., Yazdanpanah, F., & Tran, Q. K. (2021) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2021.01.058 · Cited by 49 · see citing works
Ding, H., Chen, S. H., Edwards, I., Jayasena, R., Doecke, J. D., Layland, J. J., Yang, I. A., & Maiorana, A. (2020) · Journal of Medical Internet Research · doi:10.2196/20032 · Cited by 49 · see citing works
Li, Y., YinHui, T., Yunliang, Z., & Sun, H. (2017) · Oncotarget · doi:10.18632/oncotarget.16235 · Cited by 47 · see citing works
Mortality rate and other clinical features observed in Open vs closed format intensive care units
Yang, Q., Du, J. L., & Shao, F. (2019) · Medicine · doi:10.1097/md.0000000000016261 · Cited by 47 · see citing works
Veronese, N., Honvo, G., Bruyère, O., Rizzoli, R., Barbagallo, M., Maggi, S., Smith, L., Sabico, S., Al‐Daghri, N. M., Cooper, C. C., et al. (2022) · Aging Clinical and Experimental Research · doi:10.1007/s40520-022-02289-4 · Cited by 48 · see citing works
Wang, Z.-Q., Zhu, Y.-X., Cui, L., & Qu, B. (2019) · JMIR mHealth and uHealth · doi:10.2196/14404 · Cited by 46 · see citing works
Leppanen, J., Ng, K. W., Kim, Y.-R., Tchanturia, K., & Treasure, J. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.08.041 · Cited by 45 · see citing works
Cheema, H. A., Shahid, A., Ayyan, M., Mustafa, B., Zahid, A., Fatima, M., Ehsan, M. T., Athar, F., Duric, N., & Szakmány, T. (2022) · Nutrients · doi:10.3390/nu14081600 · Cited by 45 · see citing works
Roli, L., Pecoraro, V. L., & Trenti, T. (2017) · The International Journal of Biological Markers · doi:10.5301/jbm.5000245 · Cited by 45 · see citing works
Li, C., Qu, J., Pan, S., & Qu, Y. (2018) · Journal of Orthopaedic Surgery and Research · doi:10.1186/s13018-018-0770-9 · Cited by 45 · see citing works
Cheema, H. A., Badar, A., Ehsan, M. T., Shahid, A., Ayyan, M., Azeem, S., Hussain, A., Shahid, A., Nashwan, A. J., Mikuš, M., et al. (2023) · American Journal of Obstetrics & Gynecology MFM · doi:10.1016/j.ajogmf.2023.101049 · Cited by 44 · see citing works
RetractedKani, R., Watanabe, A., Miyamoto, Y., Ejiri, K., Iwagami, M., Takagi, H., Slipczuk, L. N., Tsugawa, Y., Aikawa, T., & Kuno, T. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.123.031805 · Cited by 45 · see citing works
Tanezumab for Patients with Osteoarthritis of the Knee: A Meta-Analysis
Kan, S.-L., Li, Y., Ning, G., Yuan, Z.-F., Chen, L., Bi, M., Sun, J.-C., & Feng, S. (2016) · PLoS ONE · doi:10.1371/journal.pone.0157105 · Cited by 43 · see citing works
Current Treatments for Breast Cancer-Related Lymphoedema: A Systematic Review
Li, L., Yuan, L., Chen, X., Wang, Q., Tian, J., Yang, K., & Zhou, E. (2016) · Europe PMC (PubMed Central) · doi:10.22034/apjcp.2016.17.11.4875 · Cited by 42 · see citing works
Zhang, Z., Ni, H., & Xu, X. (2014) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2014.02.018 · Cited by 41 · see citing works
Putzu, A., Clivio, S., Belletti, A., & Cassina, T. (2017) · International Journal of Cardiology · doi:10.1016/j.ijcard.2017.10.077 · Cited by 41 · see citing works
Zhang, Z., Hong, Y., Liu, N., & Chen, Y. (2017) · Scientific Reports · doi:10.1038/s41598-017-04779-2 · Cited by 40 · see citing works
Liu, Q., Yan, W., Runqing, L., Bo, E., Liu, J., & Liu, M. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.899821 · Cited by 40 · see citing works
Nikniaz, Z., Beheshti, S., Farhangi, M. A., & Nikniaz, L. (2021) · International Journal of Eating Disorders · doi:10.1002/eat.23561 · Cited by 41 · see citing works
Shen, H., Mei, Y., Zhang, K., & Xu, X. (2021) · Frontiers in Nutrition · doi:10.3389/fnut.2021.664940 · Cited by 39 · see citing works
Lee, E. C., Kim, S. H., & Park, S. (2017) · World Journal of Gastroenterology · doi:10.3748/wjg.v23.i35.6516 · Cited by 38 · see citing works
Lin, L.-C., Chuan, M.-H., Liu, J.-H., Liao, H., Ng, L. L., Magnusson, M., Jujić, A., Pan, H., Wu, V., & Forni, L. G. (2023) · Critical Care · doi:10.1186/s13054-023-04747-5 · Cited by 37 · see citing works
Zhou, X., Pan, W., Chen, B., Xu, Z., & Pan, J. (2021) · Annals of Intensive Care · doi:10.1186/s13613-021-00909-2 · Cited by 37 · see citing works
Polymorphisms in Protamine 1 and Protamine 2 predict the risk of male infertility: a meta-analysis
Jiang, W., Sun, H. J., Zhang, J., Zhou, Q., Wu, Q., Li, T., Zhang, C., Li, W., Zhang, M., & Xia, X. (2015) · Scientific Reports · doi:10.1038/srep15300 · Cited by 37 · see citing works
Associations between anger and chronic primary pain: a systematic review and meta-analysis
Adachi, T., Yamada, K., Fujino, H., Enomoto, K., & Shibata, M. (2021) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2021-0154 · Cited by 36 · see citing works
Risk of Substantial Intraocular Bleeding With Novel Oral Anticoagulants
Caldeira, D., Canastro, M., Barra, M., Ferreira, A., Costa, J. N., Pinto, F. J., & Ferreira, J. J. (2015) · JAMA Ophthalmology · doi:10.1001/jamaophthalmol.2015.0985 · Cited by 35 · see citing works
Loh, Y. L., Yaw, Q. P., & Lau, Y. (2023) · International Journal of Obesity · doi:10.1038/s41366-023-01304-6 · Cited by 36 · see citing works
Gimenez-Aparisi, G., Guijarro-Estellés, E., Chornet-Lurbe, A., Ballesta-Martínez, S., Pardo-Hernandez, M., & Ye-Lin, Y. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e20625 · Cited by 32 · see citing works
Antibiotic therapy for adults with neurosyphilis
Buitrago-Garcia, D., Martí-Carvajal, A. J., Jimenez, A., Conterno, L. O., & Pardo, R. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011399.pub2 · Cited by 30 · see citing works
Qu, J., Xu, X., Xu, C., Ding, X., Zhang, K., & Hu, L. (2023) · Frontiers in Nutrition · doi:10.3389/fnut.2023.1214774 · Cited by 30 · see citing works
- Authors
- Zhang, Z., Xu, X., & Ni, H.
- Affiliations
- Jinhua Central Hospital (CN)
- Corresponding author
- Zhang, Zhongheng
- Venue
- Critical Care
- Published
- 2013-01-09
- Volume
- 17
- Issue
- 1
- Pages
- R2-R2
- ISSN
- 1364-8535 (ISSN-L)
- PMC
- PMC4056100
- OpenAlex
- W2066676890
- Cited by
- 295
- References
- 41
- Citations by year
- 2026: 16 · 2025: 18 · 2024: 24 · 2023: 26 · 2022: 30 · 2021: 27 · 2020: 27 · 2019: 27 · 2018: 22 · 2017: 20 · 2016: 19 · 2015: 14 · 2014: 17 · 2013: 8
- FWCI
- 21.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Critical Care (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- 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 Clinical Trials
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Keywords
- small-study effects, sample size, effect size overestimation, mortality, methodological quality of trials, allocation concealment, blinding, incomplete follow-up, meta-epidemiology
- MeSH terms
- Critical Care, Humans, Epidemiologic Studies, Randomized Controlled Trials as Topic
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.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
