The case of the misleading funnel plot

Ref ID 472
First Author J. Lau
Journal BMJ
Year Of Publishing 2006
URL https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1570006/pdf/bmj33300597.pdf
Keywords • Publication bias
• General medical
Problem(s) • Poor consideration of publication bias
Article Type Editorial
Article Subtype Discussion piece
First Author Country United States
Aim A discussion of the funnel plot to highlight that it is frequently employed in systematic reviews but is seldom wisely deployed or interpreted.
Level of Investigation Descriptive
Summary of Findings The authors highlight that funnel plots are promoted by the Cochrane handbook as a method for assessment of publication bias. However several examples from published systematic reviews discussed by the authors indicate that they are frequently deployed when too few studies or underpowered studies are included in order for such a visual inspection to be meaningful and often that publication bias is erroneously concluded or discounted on the basis of funnel plots. Specific examples are cited within the editorial.
Number of systematic reviews included 13
Number of eligible systematic reviews assessed 20
Treatment impacted No
Treatment impacted description
Interpretation impacted No
Interpretation impacted description