GRADE guidelines: 5. Rating the quality of evidence-publication bias

被引：950

作者：

Guyatt, Gordon H. ^{[1
,2
]}

Oxman, Andrew D. ^{[3
]}

Montori, Victor ^{[4
]}

Vist, Gunn ^{[3
]}

Kunz, Regina ^{[5
]}

Brozek, Jan ^{[1
]}

Alonso-Coello, Pablo ^{[6
,7
]}

Djulbegovic, Ben ^{[8
,9
,10
]}

Atkins, David ^{[11
]}

Falck-Ytter, Yngve ^{[12
]}

Williams, John W., Jr. ^{[13
]}

Meerpohl, Joerg ^{[14
,15
]}

Norris, Susan L. ^{[16
]}

Akl, Elie A. ^{[17
]}

Schuenemann, Holger J. ^{[1
]}

机构：

[1] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8N 3Z5, Canada

[2] McMaster Univ, Dept Med, Hamilton, ON L8N 3Z5, Canada

[3] Norwegian Knowledge Ctr Hlth Serv, N-0130 Oslo, Norway

[4] Mayo Clin, Knowledge & Encounter Res Unit, Rochester, MN USA

[5] Univ Basel Hosp, Basel Inst Clin Epidemiol, CH-4031 Basel, Switzerland

[6] Univ Autonoma Barcelona, Iberoamer Cochrane Ctr, Serv Epidemiol Clin & Salud Publ, Barcelona 08041, Spain

[7] Univ Autonoma Barcelona, Hosp St Pau, CIBERESP, Barcelona 08041, Spain

[8] Univ S Florida, Ctr Evidence Based Med & Hlth Outcomes Res, Tampa, FL USA

[9] H Lee Moffitt Canc Ctr & Res Inst, Dept Hematol, Tampa, FL 33612 USA

[10] H Lee Moffitt Canc Ctr & Res Inst, Dept Hlth Outcomes & Behav, Tampa, FL 33612 USA

[11] US EPA, Off Res & Dev, QUERI Program, Dept Vet Affairs, Washington, DC 20460 USA

[12] Case Western Reserve Univ, Dept Med, Div Gastroenterol, Case & VA Med Ctr, Cleveland, OH 44106 USA

[13] Duke Univ, Med Ctr, Durham VA Ctr Hlth Serv Res Primary Care, Durham, NC 27705 USA

[14] Univ Med Ctr Freiburg, German Cochrane Ctr, Inst Med Biometry & Med Informat, D-79104 Freiburg, Germany

[15] Univ Med Ctr Freiburg, Dept Pediat & Adolescent Med, Div Pediat Hematol & Oncol, D-79106 Freiburg, Germany

[16] Oregon Hlth & Sci Univ, Dept Med Informat & Clin Epidemiol, Portland, OR 97239 USA

[17] SUNY Buffalo, Dept Med, Buffalo, NY 14260 USA

来源：

JOURNAL OF CLINICAL EPIDEMIOLOGY | 2011年 / 64卷 / 12期

关键词：

GRADE; Quality of evidence; Publication bias; Funnel plot; Conflict of interest; Pharmaceutical industry; CLINICAL-TRIAL REGISTRATION; ESTIMATING EFFECT SIZE; GRAPHICAL TEST; PHARMACEUTICAL-INDUSTRY; DUPLICATE PUBLICATION; FUNNEL PLOT; METAANALYSIS; DRUG; SALMETEROL; MEDICINE;

D O I：

10.1016/j.jclinepi.2011.01.011

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

100404 [儿少卫生与妇幼保健学];

摘要：

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. (C) 2011 Elsevier Inc. All rights reserved.

引用

页码：1277 / 1282

页数：6

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