Papageorgiou Spyridon N, Dimitraki Dionysia, Coolidge Trilby, Kotsanos Nikolaos
Department of Orthodontics, School of Dentistry, University of Bonn, Bonn, Germany; Department of Oral Technology, School of Dentistry, University of Bonn, Bonn, Germany; Clinical Research Unit 208, University of Bonn, Bonn, Germany.
Department of Paediatric Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
J Evid Based Dent Pract. 2015 Mar;15(1):8-24. doi: 10.1016/j.jebdp.2014.09.001. Epub 2014 Oct 30.
The aim of this study was to examine the presence and extent of publication bias and small-study effects in meta-analyses (MAs) investigating pediatric dentistry-related subjects.
Following a literature search, 46 MAs including 882 studies were analyzed qualitatively. Of these, 39 provided enough data to be re-analyzed. Publication bias was assessed with the following methods: contour-enhanced funnel plots, Begg and Mazumdar's rank correlation and Egger's linear regression tests, Rosenthal's failsafe N, and Duval and Tweedie's "trim and fill" procedure.
Only a few MAs adequately assessed the existence and effect of publication bias. Inspection of the funnel plots indicated asymmetry, which was confirmed by Begg-Mazumdar's test in 18% and by Egger's test in 33% of the MAs. According to Rosenthal's criterion, 80% of the MAs were robust, while adjusted effects with unpublished studies differed from little to great from the unadjusted ones. Pooling of the Egger's intercepts indicated that evidence of asymmetry was found in the pediatric dental literature, which was accentuated in dental journals and in diagnostic MAs. Since indications of small-study effects and publication bias in pediatric dentistry were found, the influence of small or missing trials on estimated treatment effects should be routinely assessed in future MAs.
本研究旨在调查在有关儿童牙科相关主题的荟萃分析（MA）中发表偏倚和小研究效应的存在情况及程度。
在进行文献检索后，对46项包含882项研究的MA进行了定性分析。其中，39项提供了足够的数据以便重新分析。采用以下方法评估发表偏倚：等高线增强漏斗图、Begg和Mazumdar等级相关检验、Egger线性回归检验、Rosenthal失效安全数N以及Duval和Tweedie的“修剪与填充”程序。
仅有少数MA充分评估了发表偏倚的存在及影响。对漏斗图的检查显示存在不对称性，Begg - Mazumdar检验在18%的MA中证实了这一点，Egger检验在33%的MA中证实了这一点。根据Rosenthal标准，80%的MA是稳健的，而纳入未发表研究后的调整效应与未调整效应相比，差异从微小到显著不等。对Egger截距的合并分析表明，在儿童牙科文献中发现了不对称性证据，在牙科期刊和诊断性MA中这种情况更为突出。由于在儿童牙科中发现了小研究效应和发表偏倚的迹象，未来的MA应常规评估小型或缺失试验对估计治疗效应的影响。
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