ReviewNephrology (Carlton, Vic.)2021
Funnel plots of patient-reported outcomes to evaluate health-care quality: Basic principles, pitfalls and considerations.
Review in Nephrology (Carlton, Vic.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Perils of Misinterpreting and Misusing "Publication Bias" in Meta-analyses: An Education Review on Funnel Plot-Based Methods.Sports medicine (Auckland, N.Z.) · 2024Pooled it
- The immaturity of patient engagement in value-based healthcare-A systematic review.Frontiers in public health · 2023Pooled it
- Assessing the real-world value of hemophilia care: how suitable are patient-centered outcomes for hospital-level comparisons?International journal for quality in health care : journal of the International Society for Quality in Health Care · 2026Article
- Article
- Ninety-Day Cost, Mortality and Hospital Disparities in Ischemic Stroke: Real-World Evidence from a Czech Administrative Database.Healthcare (Basel, Switzerland) · 2026Article
- Does Generative Artificial Intelligence Improve Students' Higher-Order Thinking? A Meta-Analysis Based on 29 Experiments and Quasi-Experiments.Journal of Intelligence · 2025Review
- Deciphering the causal link between gut microbiota and membranous nephropathy: insights into potential inflammatory mechanisms.Renal failure · 2025Article
- A method to identify prescription drug targets for health technology reassessment.International journal of technology assessment in health care · 2025Article
- Genetic association between serum 25-hydroxyvitamin D levels and functional outcome after ischemic stroke.BMC neurology · 2024Article
- Optimizing Hospital Performance Evaluation in Total Weight Loss Outcomes After Bariatric Surgery: A Retrospective Analysis to Guide Further Improvement in Dutch Hospitals.Obesity surgery · 2024Article
- Age at first sexual intercourse, age at menarche, and age at menopause: a mendelian randomization study on lung cancer risk.Translational lung cancer research · 2024Article
- Review
- Funnel plots a graphical instrument for the evaluation of population performance and quality of trauma care: a blueprint of implementation.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Observational
- Facing the challenges of PROM implementation in Dutch dialysis care: Patients' and professionals' perspectives.PloS one · 2023Article
- Article
- Funnel plots of patient-reported outcomes to evaluate health-care quality: Basic principles, pitfalls and considerations.Nephrology (Carlton, Vic.) · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A funnel plot is a graphical method to evaluate health-care quality by comparing hospital performances on certain outcomes. So far, in nephrology, this method has been applied to clinical outcomes like mortality and complications. However, patient-reported outcomes (PROs; eg, health-related quality of life [HRQOL]) are becoming increasingly important and should be incorporated into this quality assessment. Using funnel plots has several advantages, including clearly visualized precision, detection of volume-effects, discouragement of ranking hospitals and easy interpretation of results. However, without sufficient knowledge of underlying methods, it is easy to stumble into pitfalls, such as overinterpretation of standardized scores, incorrect direct comparisons of hospitals and assuming a hospital to be in-control (ie, to perform as expected) based on underpowered comparisons. Furthermore, application of funnel plots to PROs is accompanied by additional challenges related to the multidimensional nature of PROs and difficulties with measuring PROs. Before using funnel plots for PROs, high and consistent response rates, adequate case mix correction and high-quality PRO measures are required. In this article, we aim to provide insight into the use and interpretation of funnel plots by presenting an overview of the basic principles, pitfalls and considerations when applied to PROs, using examples from Dutch routine dialysis care.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.