Bias in meta-analysis detected by a simple, graphical test

British Medical Journal

Volumn 315, Issue 7109, 1997, Pages 629-634

  Egger, Matthias ^a   Smith, George Davey ^a   Schneider, Martin ^b   Minder, Christoph ^b  

^a UNIVERSITY OF BRISTOL   (United Kingdom)

^b UNIVERSITY OF BERN   (Switzerland)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; MEDICAL LITERATURE; MEDICAL RESEARCH; META ANALYSIS; PRIORITY JOURNAL; SAMPLE; STATISTICAL ANALYSIS;

EID: 0030922816     PISSN: 09598146     EISSN: None     Source Type: Journal    
DOI: 10.1136/bmj.315.7109.629     Document Type: Article

References (47)

1. Chalmers I, Dickersin K, Chalmers TC, Getting to grips with Archie Cochrane's agenda. BMJ 1992;305:786-8.
2. Mulrow CD. Rationale for systematic reviews. BMJ 1994;309:597-9.
3. Huque MF. Experiences with meta-analysis in NDA submissions. proc Biopharmaceutical Section Am Statist Assoc 1988;2:28-33.
4. Egger M, Davey Smith G. Misleading meta-analysis. Lessons from "an effective, sale, simple" intervention that wasn't, BMJ 1995;310:752-4.
5. Eysenck HJ. An exercise in mega-silliness. Am Psychol 1978;33:517.
6. Easterbrook PJ, Berlin JA, Gopalan R, Matthews DR. Publication bias in clinical research. Lamet 1991;337:867-72.
7. Gøtzsche PC. Reference bias in reports of drug trials. BMJ 1987;295:654-6.
8. Egger M, Zellweger-Zäluner T, Schneider M, Junker C, Lengeler C, Antes G. Language bias in randomised controlled trials published in English and German. Lancet 1997;350:326-9.
9. Egger M, Davey Smith G. Meta-analysis: bias in location and selection of studies. BMJ (in press).
10. Light RJ, Pillemer DB. Summing up. The science of reviewing research. Cambridge, MA: Harvard University Press, 1984.
11. Villar J, Piaggio G, Carroli G, Donner A. Factors aflecting the comparability of meta-analyses and largest trials results in perinatology. J Clin Epidemiol 1997;50:997-1002.
12. Galbraith R. A note on graphical presentation of estimated odds ratios from several clinical trials. Stat Med 1988;7:889-94.
13. Cappelleri JC, Ioannidis JPA, Schmid CH, de Ferranti SD, Aubert M, Ghalmers TG. et al. Large trials vs meta-analysis of smaller trials. How do their results compare? JAMA 1996;276:1332-8.
14. Stock AK, Sin AI., Wieland GD, Adams J, Rubenstein LZ. Comprehensive geriatric assessment a meta-analysis of controlled trials. Lancet 1993; 342:1032-6.
15. SOLVD investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl Med 1991;325:293-302.
16. The Cochrane Database of Systematic Reviews. Oxford: Cochrane Collaboration, 1996.
17. Yusuf S, Collins R, Peto R, Eurberg G, Stampfer MJ, Goldhaber SZ, et al. Intravenous and intracoronary fibrinolytic therapy in acute myocardial infarction: overview of results on mortality, reinfarction and side-effects from 33 randomized controlled trials. Eur Heart J 1985;6:556-85.
18. Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto Miocaidico (GISSI). Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 1986;i:397-402.
19. Yusuf S, Peto R, Lewis J, Collins R, Sleight P. Beta blockade during and alter myocardial infarction: an overview of the randomized trials. Progr Cardiovast Dis 1985;17:335-71.
20. ISIS-1 Collaborative Group. Randomised trial of intravenous atenolol among 16027 cases of suspected acute myocardial infarction: ISIS-I. Lancet 1986;ii:57-66.
21. Wang PH, Lau J, Chalmers TC. Mela-analysis of effetts of intensive blood-glucose control on late complications of type 1 diabetes. Lancet 1993;341:1306-9.
22. Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329:977-86.
23. Reuben DB, Borok GM, Wolde-Tsadik G, Ershoff DH, Fishman LK, Ambrosini VL, et al. Randomized trial of comprehensive geriatric assessment in the care of hospitalized patients. N Engl J Med 1995;332:1345-50.
24. Yusuf S. Collins R, MacMahon S. Peto R. Effect of intravenous nitrates on mortality in acute myocardial infarction: an overview of the randomised trials. Lancet 1988;i:1088-92.
25. Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto Miocardico (GISSI). GISSI-3: effects of lisinopril and transdermal glyceryl trinitrate singly and together on 6-week mortality and ventricular function after acute myocardial infarction. Lancet 1994;343:1115-22.
26. Mulrow CD, MulrowJP, Linn WD, Aguilar C, Ramirez G. Relative efficacy of vasodilator therapy in chronic congestive heart failure. JAMA 1988;259:3422-6.
27. Teo KK. Yusuf S. Role of magnesium in reducing mortality in acute myocardial infarction. A review of the evidence. Drugs 1993;16:347-59.
28. ISIS-4 Collaborative Group. ISIS-4: a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. Lancet 1995;345:669-87.
29. Imperiale TF, Stollenwerk Petrullis A. A meta-analysis of low-dose aspirin for the prevention of pregnancy-induced hypertensive disease. JAMA 1991;266:264-5.
30. CLASP Collaborative Group. CLASP: a randomized trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnant women. Lancet 1994;343:619-29.
31. Garg R, Yusuf S for the Collaborative Group on ACE Inhibitor Trials. Overview of randomised trials of angioterisin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. JAMA 1995;273:1450-6.
32. Collins R. Antiplatelet agents for IUGR and pre-eclampsia. In: Enkin MW. Keirse MJNC, Renfrew MJ, Neilson JP, eds. Pregnancy and childbirth module, Cochrane Database of Systematic Reviews. Oxford: Update Software, 1994. (Review No 04000, 12 March 1994. Cochrane Updates or Disk, disk issue 3.)
33. Chalmers I. Underreporting research is scientific misconduct. JAMA 1990;263:1405-8.
34. Levy C. Publication bias: its implications for clinical pharmacology. Clin Pharmacol Ther 1992;52:115-9.
35. Savulescu J. Chalmers I, Blunt J. Are research ethics committees behaving unethically? Some suggestions for improving performances and accountability. BMJ 1996;313:1390-3.
36. Ravnskov U. Cholesterol lowering trials in coronary heart disease: frequency of citation and outcome. BMJ 1992;305:15-9.
37. Huston P, Moher D. Redundancy, disaggregaiion, and the integrity of medical research. Lancet 1996;347:1024-6.
38. Chalmers TC, Celano P, Sacks HS, Smith H. Bias in treatment assignment in controlled clinical trials. N Engl J Med 1983;309:1358-601.
39. Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995;273:408-12.
40. Altman DG. The scandal of poor medical research. BMJ 1994;308:283-4.
41. Egger M, Davey Smith C, Phillips AN. Meta-analysis: principles and procedures. BMJ (in press).
42. Davey Smith G, Egger M. Who benefits from medical interventions? Treating low risk patients can be a high risk strategy. BMJ 1994;308:72-4.
43. Baxter GF, Sumeray MS, Walker JM. Infarct size and magnesium: insights into LIMIT-2 and ISIS-4 from experimental studies. Lancet 1996;318: 1424-6.
44. Collins R, Peto R. Magnesium in acute myocardial infarction. Lancet 1997;349:282.
45. Villar J, Carroli G, Belizan JM. Hredictive ability of meta-analyses of randomised controlled trials. Lancet 1995;345:772-6.
46. Flournoy N, Olkin I. Do small trials square with large ones? Lancet 1995;345:741-2.
47. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994;50:1088-99.