ArticleThe journal of evidence-based dental practice2023
THE EFFECT DIRECTION SHOULD BE TAKEN INTO ACCOUNT WHEN ASSESSING SMALL-STUDY EFFECTS.
Article in The journal of evidence-based dental practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
What it found
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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.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Associations between obstructive sleep apnea and Alzheimer's disease-related biomarkers (amyloid-β and tau) in blood and cerebrospinal fluid: a systematic review and meta-analysis.Frontiers in neurology · 2026Pooled it
- Pooled it
- Pooled it
- Impact of traditional Korean medicine on suicide prevention in depression: A nationwide 10-year follow-up study.Journal of traditional and complementary medicine · 2026Article
- Leveraging AI for Meta-Analysis: Evaluating LLMs in Detecting Publication Bias for Next-Generation Evidence Synthesis.Cochrane evidence synthesis and methods · 2025Article
- Role of zinc finger protein 71 in hepatocellular carcinoma: Methodological concerns, clinical relevance, and future directions.World journal of hepatology · 2025Article
- Assessment of inverse publication bias in safety outcomes: an empirical analysis.BMC medicine · 2024Article
- Methods for assessing inverse publication bias of adverse events.Contemporary clinical trials · 2024Article
- Sensitivity analysis with iterative outlier detection for systematic reviews and meta-analyses.Statistics in medicine · 2024Article
- Review
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
objectiveStudies with statistically significant results are frequently more likely to be published than those with non-significant results. This phenomenon leads to publication bias or small-study effects and can seriously affect the validity of the conclusion from systematic reviews and meta-analyses. Small-study effects typically appear in a specific direction, depending on whether the outcome of interest is beneficial or harmful, but this direction is rarely taken into account in conventional methods.
methodsWe propose to use directional tests to assess potential small-study effects. The tests are built on a one-sided testing framework based on the existing Egger's regression test. We performed simulation studies to compare the proposed one-sided regression tests, conventional two-sided regression tests, as well as two other competitive methods (Begg's rank test and the trim-and-fill method). Their performance was measured by type I error rates and statistical power. Three real-world meta-analyses on measurements of infrabony periodontal defects were also used to examine the various methods' performance.
resultsBased on simulation studies, the one-sided tests could have considerably higher statistical power than competing methods, particularly their two-sided counterparts. Their type I error rates were generally controlled well. In the case study of the three real-world meta-analyses, by accounting for the favored direction of effects, the one-sided tests could rule out potential false-positive conclusions about small-study effects. They also are more powerful in assessing small-study effects than the conventional two-sided tests when true small-study effects likely exist.
conclusionWe recommend researchers incorporate the potential favored direction of effects into the assessment of small-study effects.
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